| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $602.56 | $602.56 | $602.56 | |
Aetna
| Professional | $501.19 | $588.84 | $630.96 | |
CareSource
| Facility | $1,000.00 | $1,000.00 | $1,000.00 | |
CareSource
| Professional | $891.25 | $891.25 | $891.25 | |
United
| Professional | $309.03 | $331.13 | $933.25 |