| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $194.36 | $194.36 | $504.00 | |
Aetna
| Professional | $194.36 | $225.65 | $226.10 | |
CareSource
| Facility | $708.36 | $2,833.43 | $5,666.86 | |
CareSource
| Professional | $119,998.80 | $119,998.80 | $119,998.80 | |
Cigna
| Facility | $221.20 | $223.70 | $746.81 | |
Cigna
| Professional | $935.47 | $935.47 | $935.47 | |
United
| Professional | $108.86 | $217.78 | $368.03 |