| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $165.65 | $165.65 | $331.30 | |
Aetna
| Professional | $33.61 | $202.27 | $202.27 | |
CareSource
| Facility | $108.11 | $478.60 | $1,013.52 | |
CareSource
| Professional | $119,998.80 | $119,998.80 | $119,998.80 | |
Cigna
| Facility | $37.28 | $37.28 | $298.05 | |
Cigna
| Professional | $155.93 | $155.93 | $155.93 | |
United
| Professional | $87.24 | $194.21 | $388.32 |