| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $307.69 | $307.69 | $2,300.00 | |
CareSource
| Facility | $323.50 | $358.20 | $390.26 | |
Cigna
| Facility | $346.78 | $346.78 | $346.78 | |
United
| Facility | $4,542.60 | $4,542.60 | $4,542.60 |