| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $606.23 | $606.23 | $606.23 | |
Aetna
| Professional | $466.44 | $548.70 | $707.40 | |
CareSource
| Facility | $60.00 | $124.61 | $161.53 | |
CareSource
| Professional | $60.00 | $64.61 | $110.76 | |
Cigna
| Facility | $872.40 | $872.40 | $872.40 | |
Cigna
| Professional | $65.25 | $643.37 | $3,648.31 | |
United
| Professional | $332.92 | $394.28 | $815.63 |