| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $193.28 | $193.28 | $1,400.00 | |
Aetna
| Professional | $193.28 | $200.86 | $224.86 | |
CareSource
| Facility | $192.88 | $221.27 | $241.07 | |
CareSource
| Professional | $214.28 | $214.28 | $214.28 | |
Cigna
| Facility | $206.17 | $206.17 | $206.17 | |
Cigna
| Professional | $172.12 | $282.82 | $841.91 | |
United
| Professional | $156.01 | $258.86 | $386.61 |