| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $137.81 | $137.81 | $137.81 | |
Aetna
| Professional | $137.81 | $138.52 | $154.26 | |
CareSource
| Facility | $76.84 | $90.22 | $179.47 | |
CareSource
| Professional | $79.33 | $79.33 | $79.33 | |
Cigna
| Facility | $165.54 | $165.54 | $6,226.64 | |
Cigna
| Professional | $119.52 | $324.68 | $2,330.17 | |
United
| Professional | $133.33 | $321.20 | $793.89 |