| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $83.54 | $83.54 | $167.08 | |
Aetna
| Professional | $83.54 | $89.04 | $106.95 | |
CareSource
| Facility | $334.15 | $1,479.33 | $2,923.84 | |
CareSource
| Professional | $119,998.80 | $119,998.80 | $119,998.80 | |
Cigna
| Facility | $96.94 | $96.94 | $96.94 | |
Cigna
| Professional | $366.37 | $366.37 | $366.37 | |
United
| Professional | $70.54 | $98.14 | $158.66 |