| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $66.42 | $120.86 | $1,600.00 | |
Aetna
| Professional | $66.42 | $105.52 | $135.68 | |
CareSource
| Facility | $72.77 | $81.72 | $89.03 | |
CareSource
| Professional | $79.14 | $79.14 | $79.14 | |
Cigna
| Facility | $116.69 | $116.69 | $116.69 | |
Cigna
| Professional | $65.95 | $122.91 | $321.16 | |
United
| Professional | $102.56 | $149.37 | $223.81 |