| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.14 | $14.14 | $14.14 | |
Aetna
| Professional | $13.81 | $14.14 | $14.14 | |
CareSource
| Facility | $44,999.55 | $44,999.55 | $69,999.30 | |
Cigna
| Professional | $13.15 | $13.15 | $13.15 |