| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $191.54 | $297.08 | $1,600.00 | |
CareSource
| Facility | $205.70 | $230.08 | $250.67 | |
Cigna
| Facility | $218.88 | $218.88 | $218.88 | |
United
| Facility | $1,225.00 | $1,225.00 | $1,225.00 |