| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,300.00 | $28,247.94 | $28,247.94 | |
CareSource
| Facility | $359.88 | $397.79 | $433.39 | |
Cigna
| Facility | $577.05 | $577.05 | $577.05 | |
United
| Facility | $4,439.00 | $4,439.00 | $4,439.00 |