| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,778.28 | $1,778.28 | $1,778.28 | |
Cigna
| Facility | $100.00 | $100.00 | $100.00 | |
Quartz
| Facility | $100.00 | $100.00 | $100.00 | |
United
| Facility | $2,630.27 | $2,630.27 | $2,630.27 |