| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,174.90 | $1,174.90 | $1,412.54 | |
CareSource
| Facility | $1,445.44 | $1,445.44 | $1,445.44 | |
Cigna
| Facility | $34.67 | $1,862.09 | $1,862.09 | |
United
| Facility | $758.58 | $758.58 | $758.58 |