| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $546.66 | $890.37 | $1,600.00 | |
CareSource
| Facility | $623.23 | $689.52 | $751.25 | |
Cigna
| Facility | $675.90 | $675.90 | $675.90 | |
United
| Facility | $20,028.63 | $20,028.63 | $20,028.63 |