| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $159.13 | $1,821.00 | $9,477.00 | |
Aetna
| Professional | $145.01 | $159.13 | $169.58 | |
CareSource
| Facility | $260.39 | $260.39 | $260.39 | |
CareSource
| Professional | $209.13 | $217.49 | $402.48 |