| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $41.45 | $41.45 | $82.90 | |
Aetna
| Professional | $40.69 | $49.01 | $49.01 | |
CareSource
| Facility | $135.18 | $598.45 | $1,267.32 | |
CareSource
| Professional | $119,998.80 | $119,998.80 | $119,998.80 | |
Cigna
| Facility | $45.48 | $45.48 | $45.48 | |
Cigna
| Professional | $190.20 | $190.20 | $190.20 | |
United
| Professional | $24.37 | $47.83 | $84.06 |