| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $79.00 | $79.00 | $79.00 | |
Aetna
| Professional | $79.00 | $79.00 | $79.00 | |
CareSource
| Facility | $349.83 | $349.83 | $44,999.55 | |
Cigna
| Professional | $91.00 | $91.00 | $91.00 | |
United
| Professional | $195.94 | $195.94 | $283.77 |