| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $107.15 | $107.15 | $1,584.89 | |
CareSource
| Facility | $112.20 | $112.20 | $131.83 | |
Cigna
| Facility | $34.67 | $177.83 | $177.83 | |
United
| Facility | $1,230.27 | $1,230.27 | $4,365.16 |