| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,557.09 | $1,557.09 | $1,557.09 | |
Aetna
| Professional | $928.11 | $1,557.09 | $1,557.09 | |
CareSource
| Facility | $891.00 | $8,910.00 | $13,365.00 | |
CareSource
| Professional | $9,720.00 | $9,720.00 | $9,720.00 |