| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $84.95 | $84.95 | $84.95 | |
Aetna
| Professional | $60.04 | $84.95 | $84.95 | |
CareSource
| Facility | $35,999.64 | $44,999.55 | $69,999.30 | |
Cigna
| Professional | $202.00 | $202.00 | $202.00 | |
United
| Facility | $233.00 | $233.00 | $233.00 | |
United
| Professional | $320.00 | $320.00 | $320.00 |