| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $492.00 | $750.00 | $900.00 | |
Aetna
| Professional | $450.00 | $492.00 | $510.00 | |
CareSource
| Facility | $810.00 | $3,375.00 | $16,200.00 | |
CareSource
| Professional | $720.00 | $810.00 | $119,998.80 | |
Cigna
| Facility | $487.50 | $720.00 | $1,799.85 | |
Cigna
| Professional | $2,892.00 | $2,892.00 | $2,892.00 | |
United
| Professional | $252.00 | $300.00 | $870.00 |