| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $156.16 | $162.97 | $185.50 | |
Aetna
| Professional | $162.97 | $162.97 | $196.09 | |
CareSource
| Facility | $162.97 | $244.47 | $244.47 | |
Cigna
| Facility | $153.75 | $180.20 | $203.81 | |
Cigna
| Professional | $203.81 | $203.81 | $506.79 | |
United
| Professional | $162.97 | $218.36 | $218.36 |