| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $196.00 | $345.60 | $345.60 | |
Aetna
| Professional | $30.00 | $50.00 | $345.60 | |
CareSource
| Facility | $18.26 | $71.02 | $170.44 | |
CareSource
| Professional | $34.60 | $122.53 | $316.20 | |
Cigna
| Professional | $126.00 | $180.00 | $258.00 | |
United
| Professional | $45.00 | $60.00 | $71.00 |