| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $85.55 | $85.55 | $1,400.00 | |
Aetna
| Professional | $77.17 | $85.55 | $101.01 | |
CareSource
| Facility | $100.64 | $100.64 | $100.64 | |
CareSource
| Professional | $49.99 | $49.99 | $92.26 | |
Cigna
| Facility | $93.41 | $93.41 | $93.41 | |
Cigna
| Professional | $78.19 | $116.93 | $239.86 | |
United
| Professional | $69.59 | $104.11 | $152.43 |