| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $38.58 | $38.58 | $77.16 | |
Aetna
| Professional | $38.58 | $47.09 | $47.09 | |
CareSource
| Facility | $101.16 | $447.85 | $948.38 | |
CareSource
| Professional | $119,998.80 | $119,998.80 | $119,998.80 | |
Cigna
| Facility | $35.40 | $223.40 | $397.41 | |
Cigna
| Professional | $146.58 | $146.58 | $146.58 | |
United
| Professional | $25.66 | $39.97 | $74.62 |