| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.20 | $75.20 | $1,400.00 | |
Aetna
| Professional | $70.95 | $82.23 | $96.61 | |
CareSource
| Facility | $248.97 | $1,175.71 | $2,323.75 | |
CareSource
| Professional | $119,998.80 | $119,998.80 | $119,998.80 | |
Cigna
| Facility | $84.96 | $84.96 | $84.96 | |
Cigna
| Professional | $353.93 | $353.93 | $353.93 | |
United
| Professional | $63.02 | $103.24 | $137.57 |