| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $380.19 | $501.19 | $1,412.54 | |
CareSource
| Facility | $416.87 | $416.87 | $501.19 | |
Cigna
| Facility | $676.08 | $676.08 | $676.08 | |
United
| Facility | $1,230.27 | $1,230.27 | $4,365.16 |