| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $48.36 | $174.51 | $1,400.00 | |
Aetna
| Professional | $43.72 | $74.72 | $229.60 | |
CareSource
| Facility | $52.22 | $57.86 | $63.05 | |
CareSource
| Professional | $56.04 | $56.04 | $56.04 | |
Cigna
| Facility | $83.74 | $83.74 | $83.74 | |
Cigna
| Professional | $56.04 | $179.27 | $498.48 | |
United
| Facility | $460.00 | $460.00 | $460.00 | |
United
| Professional | $151.46 | $220.02 | $378.93 |