| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $133.75 | $160.50 | $160.50 | |
Aetna
| Professional | $80.25 | $85.60 | $90.95 | |
CareSource
| Facility | $144.44 | $601.88 | $2,889.00 | |
CareSource
| Professional | $128.40 | $144.44 | $119,998.80 | |
Cigna
| Facility | $86.94 | $128.40 | $320.97 | |
Cigna
| Professional | $515.74 | $515.74 | $515.74 | |
United
| Professional | $44.94 | $53.50 | $155.15 |