| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $162.07 | $162.07 | $1,600.00 | |
CareSource
| Facility | $184.10 | $204.08 | $222.36 | |
Cigna
| Facility | $199.18 | $199.18 | $199.18 | |
United
| Facility | $8,914.33 | $8,914.33 | $8,914.33 |