| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,412.54 | $1,737.80 | $1,737.80 | |
CareSource
| Facility | $1,905.46 | $1,905.46 | $2,290.87 | |
Cigna
| Facility | $34.67 | $3,019.95 | $3,019.95 | |
United
| Facility | $758.58 | $758.58 | $758.58 |