| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $37.61 | $37.61 | $37.61 | |
Aetna
| Professional | $30.72 | $39.57 | $44.99 | |
CareSource
| Facility | $140.08 | $638.37 | $1,313.22 | |
CareSource
| Professional | $119,998.80 | $119,998.80 | $119,998.80 | |
Cigna
| Facility | $46.97 | $46.97 | $46.97 | |
Cigna
| Professional | $196.46 | $196.46 | $196.46 | |
United
| Professional | $31.42 | $48.90 | $85.38 |