| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $432.88 | $432.88 | $1,400.00 | |
Aetna
| Professional | $329.76 | $427.52 | $495.58 | |
CareSource
| Facility | $1,432.05 | $6,762.44 | $13,907.88 | |
CareSource
| Professional | $119,998.80 | $119,998.80 | $119,998.80 | |
United
| Professional | $362.76 | $571.11 | $836.08 |