| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $144.06 | $144.06 | $288.12 | |
Aetna
| Professional | $144.06 | $175.90 | $175.90 | |
CareSource
| Facility | $111.38 | $493.11 | $1,044.23 | |
CareSource
| Professional | $119,998.80 | $119,998.80 | $119,998.80 | |
Cigna
| Facility | $38.40 | $181.60 | $323.04 | |
Cigna
| Professional | $160.60 | $160.60 | $160.60 | |
United
| Professional | $27.56 | $142.61 | $278.70 |