| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $157.72 | $157.72 | $157.72 | |
Aetna
| Professional | $150.41 | $172.58 | $200.64 | |
CareSource
| Facility | $157.16 | $168.66 | $183.76 | |
CareSource
| Professional | $83.64 | $154.61 | $163.34 | |
Cigna
| Facility | $188.27 | $188.27 | $188.27 | |
Cigna
| Professional | $149.91 | $190.03 | $380.11 | |
United
| Professional | $128.13 | $196.73 | $350.30 |