| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $105.65 | $105.65 | $105.65 | |
Aetna
| Professional | $81.34 | $105.65 | $238.38 | |
CareSource
| Facility | $199.77 | $943.34 | $1,864.49 | |
CareSource
| Professional | $119,998.80 | $119,998.80 | $119,998.80 | |
Cigna
| Facility | $92.46 | $92.46 | $92.46 | |
Cigna
| Professional | $346.77 | $346.77 | $346.77 | |
United
| Professional | $44.49 | $83.64 | $201.85 |