| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $338.34 | $338.34 | $1,400.00 | |
Aetna
| Professional | $338.34 | $363.35 | $425.88 | |
CareSource
| Facility | $178.23 | $243.05 | $375.26 | |
CareSource
| Professional | $194.44 | $333.56 | $72,899.27 | |
Cigna
| Facility | $371.76 | $371.76 | $371.76 | |
Cigna
| Professional | $266.95 | $471.11 | $1,557.53 | |
United
| Professional | $174.31 | $262.18 | $435.79 |