| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $44.27 | $44.27 | $44.27 | |
Aetna
| Professional | $42.69 | $49.61 | $55.33 | |
CareSource
| Facility | $175.28 | $684.71 | $1,533.73 | |
CareSource
| Professional | $119,998.80 | $119,998.80 | $119,998.80 | |
Cigna
| Facility | $58.90 | $58.90 | $58.90 | |
Cigna
| Professional | $70.62 | $246.35 | $246.35 | |
United
| Professional | $32.53 | $47.55 | $72.56 |