| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $566.70 | $566.70 | $1,700.00 | |
CareSource
| Facility | $587.80 | $639.04 | $696.25 | |
Cigna
| Facility | $634.54 | $634.54 | $634.54 | |
United
| Facility | $6,394.40 | $6,394.40 | $6,394.40 |