| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $120.54 | $586.26 | $1,700.00 | |
Aetna
| Professional | $108.35 | $188.64 | $793.48 | |
CareSource
| Facility | $132.38 | $146.09 | $159.16 | |
CareSource
| Professional | $141.47 | $141.47 | $141.47 | |
Cigna
| Facility | $212.26 | $212.26 | $212.26 | |
Cigna
| Professional | $141.47 | $576.86 | $2,072.69 | |
United
| Professional | $559.82 | $895.33 | $1,632.66 |