| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $294.00 | $518.40 | $518.40 | |
Aetna
| Professional | $30.00 | $50.00 | $518.40 | |
CareSource
| Facility | $27.39 | $109.57 | $255.66 | |
CareSource
| Professional | $56.92 | $200.87 | $474.30 | |
Cigna
| Professional | $770.34 | $770.34 | $770.34 | |
United
| Professional | $45.00 | $55.13 | $73.00 |