| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $195.48 | $282.70 | $368.88 | |
CareSource
| Professional | $224.84 | $224.84 | $224.84 | |
Cigna
| Professional | $224.84 | $370.81 | $958.84 | |
United
| Professional | $250.63 | $395.35 | $660.05 |