| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $65.67 | $65.67 | $77.26 | |
Aetna
| Professional | $65.67 | $65.67 | $72.23 | |
CareSource
| Facility | $99.09 | $61,249.40 | $122,362.78 | |
Cigna
| Facility | $65.67 | $72.25 | $72.25 | |
Cigna
| Professional | $72.25 | $72.25 | $98.12 | |
United
| Professional | $47.71 | $77.26 | $93.72 |