| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $387.41 | $442.49 | $529.54 | |
CareSource
| Facility | $54.23 | $54.23 | $542.29 | |
CareSource
| Professional | $58.40 | $58.40 | $584.01 | |
Cigna
| Facility | $200.00 | $200.00 | $740.79 | |
Cigna
| Professional | $179.00 | $200.00 | $3,097.91 | |
United
| Professional | $337.94 | $498.00 | $862.20 |