| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $200.37 | $200.37 | $750.00 | |
Aetna
| Professional | $200.37 | $400.00 | $400.00 | |
CareSource
| Facility | $102.98 | $128.94 | $241.14 | |
CareSource
| Professional | $99.73 | $99.73 | $99.73 | |
Cigna
| Facility | $151.74 | $228.17 | $632.00 | |
Cigna
| Professional | $174.00 | $336.92 | $943.27 | |
United
| Professional | $126.45 | $285.80 | $495.26 |