| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $163.52 | $175.05 | $1,400.00 | |
Aetna
| Professional | $155.38 | $163.52 | $177.39 | |
CareSource
| Facility | $167.02 | $200.42 | $218.36 | |
CareSource
| Professional | $194.10 | $194.10 | $194.10 | |
Cigna
| Facility | $279.39 | $279.39 | $279.39 | |
Cigna
| Professional | $147.91 | $212.16 | $468.64 | |
United
| Professional | $149.88 | $219.52 | $325.74 |