| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $149.50 | $156.97 | $175.88 | |
Aetna
| Professional | $149.50 | $156.97 | $172.67 | |
CareSource
| Facility | $40.31 | $40.31 | $60.47 | |
Cigna
| Facility | $149.50 | $172.37 | $172.37 | |
Cigna
| Professional | $172.37 | $172.37 | $212.74 | |
United
| Professional | $149.63 | $149.63 | $153.90 |