| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $501.20 | $501.20 | $1,400.00 | |
Aetna
| Professional | $467.78 | $524.99 | $604.16 | |
CareSource
| Facility | $561.22 | $624.72 | $680.64 | |
CareSource
| Professional | $605.02 | $605.02 | $605.02 | |
Cigna
| Facility | $600.11 | $600.11 | $600.11 | |
Cigna
| Professional | $510.11 | $778.31 | $3,220.73 | |
United
| Professional | $435.50 | $667.02 | $965.09 |