| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $984.43 | $984.43 | $984.43 | |
CareSource
| Facility | $663.56 | $762.37 | $830.61 | |
CareSource
| Professional | $738.32 | $738.32 | $738.32 | |
United
| Professional | $534.46 | $815.58 | $1,264.52 |