| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $398.11 | $724.44 | $724.44 | |
Aetna
| Professional | $177.83 | $389.05 | $457.09 | |
CareSource
| Facility | $645.65 | $645.65 | $645.65 | |
CareSource
| Professional | $575.44 | $575.44 | $575.44 | |
Cigna
| Facility | $398.11 | $776.25 | $1,445.44 | |
Cigna
| Professional | $2,344.23 | $2,344.23 | $2,344.23 | |
United
| Facility | $288.40 | $288.40 | $288.40 | |
United
| Professional | $87.10 | $104.71 | $257.04 |