| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $44.63 | $44.63 | $44.63 | |
CareSource
| Facility | $35,999.64 | $66,824.33 | $82,011.67 | |
CareSource
| Professional | $72,899.27 | $72,899.27 | $82,011.67 | |
Cigna
| Professional | $145.05 | $145.05 | $145.05 |