| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $623.86 | $976.64 | $1,700.00 | |
CareSource
| Facility | $685.59 | $756.34 | $824.04 | |
Cigna
| Facility | $732.23 | $732.23 | $732.23 | |
United
| Facility | $20,028.63 | $20,028.63 | $20,028.63 |