| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $294.24 | $294.24 | $294.24 | |
CareSource
| Facility | $1,618.34 | $7,164.55 | $15,171.98 | |
CareSource
| Professional | $119,998.80 | $119,998.80 | $119,998.80 | |
United
| Professional | $138.26 | $215.07 | $609.50 |