| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $717.90 | $717.90 | $1,700.00 | |
CareSource
| Facility | $741.46 | $808.12 | $880.46 | |
Cigna
| Facility | $796.88 | $796.88 | $796.88 | |
United
| Facility | $2,450.00 | $2,450.00 | $2,450.00 |