| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.00 | $20.00 | $20.00 | |
Aetna
| Professional | $20.00 | $20.00 | $128.86 | |
CareSource
| Facility | $35,999.64 | $44,999.55 | $69,999.30 | |
Cigna
| Professional | $73.00 | $73.00 | $73.00 | |
United
| Professional | $230.00 | $230.00 | $230.00 |