| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $463.37 | $463.37 | $1,600.00 | |
CareSource
| Facility | $465.80 | $497.92 | $608.99 | |
Cigna
| Facility | $530.96 | $530.96 | $530.96 | |
United
| Facility | $10,736.03 | $10,736.03 | $10,736.03 |