| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $297.26 | $297.26 | $1,600.00 | |
CareSource
| Facility | $342.96 | $377.59 | $411.40 | |
Cigna
| Facility | $366.03 | $366.03 | $366.03 | |
United
| Facility | $2,450.00 | $2,450.00 | $2,450.00 |