| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $211.34 | $211.34 | $248.63 | |
Aetna
| Professional | $211.34 | $211.34 | $240.92 | |
CareSource
| Facility | $166.12 | $166.12 | $44,999.55 | |
Cigna
| Facility | $211.34 | $232.20 | $232.20 | |
Cigna
| Professional | $232.20 | $232.20 | $289.76 | |
United
| Professional | $207.32 | $248.63 | $264.72 |