| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $320.88 | $320.88 | $1,400.00 | |
Aetna
| Professional | $251.46 | $320.88 | $367.05 | |
CareSource
| Facility | $1,131.19 | $5,007.89 | $10,300.19 | |
CareSource
| Professional | $119,998.80 | $119,998.80 | $119,998.80 | |
Cigna
| Facility | $362.78 | $362.78 | $362.78 | |
Cigna
| Professional | $1,509.19 | $1,509.19 | $1,509.19 | |
United
| Professional | $268.64 | $453.79 | $629.44 |