| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $37.64 | $37.64 | $37.64 | |
Aetna
| Professional | $37.64 | $45.98 | $45.98 | |
CareSource
| Facility | $139.13 | $634.10 | $1,217.47 | |
CareSource
| Professional | $119,998.80 | $119,998.80 | $119,998.80 | |
Cigna
| Facility | $48.09 | $48.09 | $48.09 | |
Cigna
| Professional | $201.14 | $201.14 | $201.14 | |
United
| Professional | $33.69 | $53.14 | $102.54 |