| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $151.97 | $151.97 | $178.80 | |
Aetna
| Professional | $148.40 | $151.97 | $151.97 | |
CareSource
| Facility | $44,999.55 | $44,999.55 | $69,999.30 | |
Cigna
| Facility | $151.97 | $151.97 | $151.97 | |
Cigna
| Professional | $151.97 | $151.97 | $227.08 |