| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $405.73 | $405.73 | $1,400.00 | |
Aetna
| Professional | $308.81 | $400.36 | $464.11 | |
CareSource
| Facility | $1,342.37 | $6,338.99 | $13,035.34 | |
CareSource
| Professional | $119,998.80 | $119,998.80 | $119,998.80 | |
United
| Professional | $339.72 | $509.58 | $766.57 |