| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $237.63 | $902.49 | $1,600.00 | |
CareSource
| Facility | $254.60 | $284.83 | $310.32 | |
Cigna
| Facility | $408.24 | $408.24 | $408.24 | |
United
| Facility | $5,318.53 | $5,318.53 | $5,318.53 |