| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $624.36 | $624.36 | $624.36 | |
Aetna
| Professional | $587.63 | $624.36 | $624.36 | |
CareSource
| Facility | $32,999.67 | $44,999.55 | $44,999.55 | |
Cigna
| Facility | $624.36 | $840.48 | $840.48 | |
Cigna
| Professional | $624.36 | $624.36 | $624.36 | |
United
| Professional | $612.11 | $612.11 | $734.54 |