| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.52 | $0.52 | $0.52 | |
Aetna
| Professional | $0.52 | $0.52 | $350.47 | |
CareSource
| Facility | $170,098.30 | $170,098.30 | $170,098.30 | |
CareSource
| Professional | $125,998.74 | $139,723.60 | $170,098.30 | |
Cigna
| Professional | $6.87 | $6.87 | $525.00 |