| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $53.14 | $53.14 | $53.14 | |
Aetna
| Professional | $53.14 | $59.35 | $66.81 | |
CareSource
| Facility | $155.58 | $857.96 | $1,921.81 | |
CareSource
| Professional | $59.09 | $61.01 | $119,998.80 | |
Cigna
| Facility | $70.30 | $70.30 | $70.30 | |
Cigna
| Professional | $94.12 | $294.64 | $294.64 | |
United
| Professional | $44.39 | $62.23 | $98.27 |