| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $167.46 | $255.63 | $1,400.00 | |
CareSource
| Facility | $178.18 | $197.98 | $215.69 | |
Cigna
| Facility | $191.77 | $191.77 | $191.77 | |
United
| Facility | $3,305.76 | $3,305.76 | $3,305.76 |