| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $245.00 | $432.00 | $432.00 | |
Aetna
| Professional | $30.00 | $50.00 | $432.00 | |
CareSource
| Facility | $22.83 | $91.31 | $213.05 | |
CareSource
| Professional | $45.76 | $162.06 | $395.25 | |
Cigna
| Professional | $168.00 | $240.00 | $344.00 | |
United
| Professional | $45.00 | $56.00 | $71.00 |