| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $23.46 | $23.46 | $23.46 | |
Aetna
| Professional | $22.61 | $27.12 | $28.97 | |
CareSource
| Facility | $80.14 | $365.21 | $751.28 | |
CareSource
| Professional | $119,998.80 | $119,998.80 | $119,998.80 | |
Cigna
| Facility | $29.08 | $29.08 | $29.08 | |
Cigna
| Professional | $34.86 | $112.26 | $112.26 | |
United
| Professional | $18.32 | $25.53 | $40.25 |