| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $419.98 | $419.98 | $440.98 | |
Aetna
| Professional | $415.04 | $430.60 | $440.98 | |
CareSource
| Facility | $32,999.67 | $44,999.55 | $44,999.55 | |
Cigna
| Facility | $419.98 | $419.98 | $440.98 | |
Cigna
| Professional | $440.98 | $440.98 | $440.98 |