| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $115.82 | $5,135.00 | $11,627.00 | |
CareSource
| Facility | $100.58 | $117.09 | $146.46 | |
Cigna
| Facility | $21,571.00 | $21,571.00 | $21,571.00 | |
United
| Facility | $444.00 | $979.00 | $3,218.00 |