| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $347.09 | $347.09 | $1,400.00 | |
Aetna
| Professional | $262.68 | $317.14 | $565.72 | |
CareSource
| Facility | $915.98 | $4,325.43 | $8,895.60 | |
CareSource
| Professional | $119,998.80 | $119,998.80 | $119,998.80 | |
United
| Professional | $388.23 | $599.78 | $934.40 |