| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $186.30 | $1,821.00 | $9,477.00 | |
Aetna
| Professional | $170.01 | $186.30 | $199.40 | |
CareSource
| Facility | $312.24 | $312.24 | $312.24 | |
CareSource
| Professional | $250.78 | $260.81 | $482.63 |