| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $141.25 | $141.25 | $158.96 | |
Aetna
| Professional | $141.25 | $141.25 | $155.37 | |
CareSource
| Facility | $184.90 | $44,999.55 | $59,999.40 | |
CareSource
| Professional | $208.58 | $208.58 | $208.58 | |
Cigna
| Facility | $85.00 | $148.50 | $148.50 | |
Cigna
| Professional | $148.50 | $148.50 | $151.01 | |
United
| Professional | $158.96 | $158.96 | $202.97 |