| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $70.00 | $70.00 | $70.00 | |
Aetna
| Professional | $70.00 | $70.00 | $154.78 | |
CareSource
| Facility | $43.35 | $54.46 | $67.31 | |
CareSource
| Professional | $43.35 | $55.55 | $101.01 | |
United
| Professional | $90.00 | $90.00 | $183.00 |