| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $851.14 | $851.14 | $1,412.54 | |
CareSource
| Facility | $870.96 | $870.96 | $1,071.52 | |
Cigna
| Facility | $34.67 | $1,412.54 | $1,412.54 | |
United
| Facility | $758.58 | $758.58 | $758.58 |