| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $123.00 | $187.50 | $225.00 | |
Aetna
| Professional | $112.50 | $123.00 | $127.50 | |
CareSource
| Facility | $202.50 | $843.75 | $4,050.00 | |
CareSource
| Professional | $180.00 | $202.50 | $119,998.80 | |
Cigna
| Facility | $121.88 | $180.00 | $449.96 | |
Cigna
| Professional | $723.00 | $723.00 | $723.00 | |
United
| Professional | $63.00 | $75.00 | $217.50 |