| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $457.51 | $457.51 | $1,400.00 | |
CareSource
| Facility | $528.26 | $606.19 | $660.45 | |
Cigna
| Facility | $569.88 | $569.88 | $569.88 | |
United
| Facility | $2,450.00 | $2,450.00 | $2,450.00 |