| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $150.13 | $158.19 | $1,400.00 | |
Aetna
| Professional | $140.13 | $150.13 | $158.99 | |
CareSource
| Facility | $153.40 | $184.08 | $200.56 | |
CareSource
| Professional | $178.27 | $178.27 | $178.27 | |
Cigna
| Facility | $256.52 | $256.52 | $256.52 | |
Cigna
| Professional | $133.38 | $192.02 | $434.80 | |
United
| Professional | $135.71 | $198.55 | $293.63 |