| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $575.44 | $575.44 | $575.44 | |
Aetna
| Professional | $501.19 | $575.44 | $660.69 | |
CareSource
| Facility | $954.99 | $954.99 | $954.99 | |
CareSource
| Professional | $851.14 | $851.14 | $851.14 | |
United
| Professional | $295.12 | $316.23 | $891.25 |