| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $463.14 | $4,723.00 | $11,627.00 | |
CareSource
| Facility | $403.55 | $403.55 | $587.62 | |
Cigna
| Facility | $21,571.00 | $21,571.00 | $21,571.00 | |
United
| Facility | $444.00 | $979.00 | $3,218.00 |