| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $54.28 | $254.41 | $505.43 | |
CareSource
| Facility | $730.25 | $3,448.40 | $6,815.65 | |
CareSource
| Professional | $119,998.80 | $119,998.80 | $119,998.80 | |
Cigna
| Facility | $710.60 | $710.60 | $710.60 | |
Cigna
| Professional | $2,036.21 | $2,036.21 | $2,036.21 | |
United
| Professional | $48.85 | $67.14 | $123.09 |