| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $158.02 | $244.99 | $1,400.00 | |
Aetna
| Professional | $158.02 | $243.77 | $307.77 | |
CareSource
| Facility | $151.63 | $168.10 | $198.23 | |
CareSource
| Professional | $176.21 | $176.21 | $176.21 | |
Cigna
| Facility | $269.54 | $269.54 | $269.54 | |
Cigna
| Professional | $176.21 | $273.20 | $774.86 | |
United
| Professional | $177.41 | $245.15 | $422.20 |