| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $776.25 | $776.25 | $1,412.54 | |
CareSource
| Facility | $831.76 | $831.76 | $1,023.29 | |
Cigna
| Facility | $34.67 | $1,318.26 | $1,318.26 | |
United
| Facility | $758.58 | $758.58 | $758.58 |