| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $99.48 | $99.48 | $504.00 | |
Aetna
| Professional | $99.48 | $105.80 | $123.28 | |
CareSource
| Facility | $21.77 | $87.44 | $82,011.67 | |
CareSource
| Professional | $22.63 | $22.63 | $22.63 | |
Cigna
| Facility | $109.40 | $123.40 | $464.73 | |
Cigna
| Professional | $93.39 | $133.43 | $509.81 |