| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $608.66 | $927.84 | $1,113.41 | |
Aetna
| Professional | $556.70 | $608.66 | $630.92 | |
CareSource
| Facility | $1,002.06 | $4,175.27 | $20,041.30 | |
CareSource
| Professional | $890.72 | $1,002.06 | $119,998.80 | |
Cigna
| Facility | $603.10 | $890.72 | $2,226.65 | |
Cigna
| Professional | $3,577.74 | $3,577.74 | $3,577.74 | |
United
| Professional | $311.75 | $371.14 | $1,076.29 |