| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $927.05 | $1,112.46 | $1,112.46 | |
Aetna
| Professional | $556.23 | $630.39 | $630.39 | |
CareSource
| Facility | $1,001.21 | $4,171.72 | $20,024.28 | |
CareSource
| Professional | $889.97 | $1,001.21 | $119,998.80 | |
United
| Professional | $311.49 | $370.82 | $1,075.38 |