| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $780.70 | $780.70 | $1,700.00 | |
CareSource
| Facility | $810.03 | $879.20 | $957.91 | |
Cigna
| Facility | $879.11 | $879.11 | $879.11 | |
United
| Facility | $2,450.00 | $2,450.00 | $2,450.00 |