| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $83.54 | $83.54 | $83.54 | |
Aetna
| Professional | $46.45 | $66.51 | $93.19 | |
CareSource
| Facility | $153.77 | $726.11 | $1,435.14 | |
CareSource
| Professional | $119,998.80 | $119,998.80 | $119,998.80 | |
Cigna
| Facility | $68.59 | $68.59 | $68.59 | |
Cigna
| Professional | $230.73 | $230.73 | $230.73 | |
United
| Professional | $37.95 | $59.30 | $108.76 |