| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $763.62 | $763.62 | $2,300.00 | |
CareSource
| Facility | $801.02 | $892.92 | $972.85 | |
Cigna
| Facility | $855.20 | $855.20 | $855.20 | |
United
| Facility | $2,910.00 | $2,910.00 | $2,910.00 |