| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $27.81 | $27.94 | $192.00 | |
CareSource
| Facility | $97.56 | $431.91 | $914.63 | |
CareSource
| Professional | $119,998.80 | $119,998.80 | $119,998.80 | |
Cigna
| Facility | $33.19 | $33.19 | $33.19 | |
Cigna
| Professional | $137.18 | $137.18 | $137.18 | |
United
| Professional | $20.57 | $27.88 | $50.33 |