| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $266.16 | $266.16 | $266.16 | |
Aetna
| Professional | $266.16 | $337.51 | $337.51 | |
CareSource
| Facility | $967.68 | $4,233.60 | $8,467.20 | |
CareSource
| Professional | $119,998.80 | $119,998.80 | $119,998.80 | |
Cigna
| Facility | $334.42 | $334.42 | $1,201.02 | |
Cigna
| Professional | $1,398.52 | $1,398.52 | $1,398.52 | |
United
| Professional | $184.05 | $384.00 | $677.69 |