| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $514.04 | $519.52 | $524.71 | |
Aetna
| Professional | $508.96 | $508.96 | $524.71 | |
CareSource
| Facility | $508.96 | $763.44 | $763.44 | |
Cigna
| Facility | $480.15 | $508.96 | $513.98 | |
Cigna
| Professional | $508.96 | $508.96 | $941.50 | |
United
| Professional | $508.96 | $508.96 | $604.67 |