| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $62.68 | $62.68 | $1,400.00 | |
Aetna
| Professional | $49.09 | $62.68 | $370.53 | |
CareSource
| Facility | $157.57 | $697.59 | $1,436.09 | |
CareSource
| Professional | $119,998.80 | $119,998.80 | $119,998.80 | |
Cigna
| Facility | $70.01 | $70.01 | $70.01 | |
Cigna
| Professional | $631.41 | $631.41 | $631.41 | |
United
| Professional | $22.90 | $40.40 | $460.04 |