| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $372.25 | $1,366.50 | $1,600.00 | |
Aetna
| Professional | $372.25 | $886.01 | $1,866.44 | |
CareSource
| Facility | $372.90 | $426.07 | $601.98 | |
CareSource
| Professional | $412.63 | $412.63 | $412.63 | |
Cigna
| Facility | $597.94 | $597.94 | $597.94 | |
Cigna
| Professional | $438.92 | $1,282.67 | $3,989.49 | |
United
| Professional | $1,103.06 | $1,857.31 | $3,482.46 |