| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $68.70 | $68.70 | $68.70 | |
Aetna
| Professional | $67.09 | $68.70 | $68.70 | |
CareSource
| Facility | $44,999.55 | $44,999.55 | $69,999.30 | |
Cigna
| Professional | $72.76 | $72.76 | $72.76 | |
United
| Professional | $78.41 | $80.84 | $80.84 |