| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
CareSource
| Facility | $264.76 | $2,830.49 | $70,874.30 | |
CareSource
| Professional | $211.81 | $250.32 | $104,998.95 | |
Cigna
| Professional | $165.52 | $165.52 | $181.91 | |
Molina
| Professional | $100.00 | $100.00 | $100.00 |