| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $60.96 | $82.20 | $256.79 | |
CareSource
| Facility | $270.33 | $1,276.59 | $2,703.38 | |
CareSource
| Professional | $119,998.80 | $119,998.80 | $119,998.80 | |
United
| Professional | $67.06 | $94.57 | $151.88 |