| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $134.90 | $245.47 | $245.47 | |
Aetna
| Professional | $114.82 | $131.83 | $154.88 | |
CareSource
| Facility | $223.87 | $223.87 | $223.87 | |
CareSource
| Professional | $194.98 | $194.98 | $194.98 | |
Cigna
| Facility | $134.90 | $263.03 | $489.78 | |
Cigna
| Professional | $794.33 | $794.33 | $794.33 | |
United
| Facility | $97.72 | $97.72 | $97.72 | |
United
| Professional | $74.13 | $85.11 | $204.17 |