| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $357.28 | $357.28 | $1,700.00 | |
CareSource
| Facility | $362.99 | $410.63 | $447.38 | |
Cigna
| Facility | $387.84 | $387.84 | $387.84 | |
United
| Facility | $10,203.37 | $10,203.37 | $10,203.37 |