| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $735.45 | $735.45 | $1,700.00 | |
CareSource
| Facility | $739.60 | $799.57 | $871.14 | |
Cigna
| Facility | $822.07 | $822.07 | $822.07 | |
United
| Facility | $2,910.00 | $2,910.00 | $2,910.00 |