| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $459.42 | $459.42 | $1,700.00 | |
CareSource
| Facility | $524.49 | $579.53 | $631.41 | |
Cigna
| Facility | $560.62 | $560.62 | $560.62 | |
United
| Facility | $9,669.75 | $9,669.75 | $9,669.75 |