| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $156.38 | $3,895.36 | $3,895.36 | |
CareSource
| Facility | $161.82 | $175.98 | $191.73 | |
Cigna
| Facility | $259.48 | $259.48 | $259.48 | |
United
| Facility | $2,450.00 | $2,450.00 | $2,450.00 |