| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $518.17 | $518.17 | $518.17 | |
Aetna
| Professional | $430.09 | $430.09 | $518.17 | |
CareSource
| Facility | $617.94 | $44,999.55 | $69,999.30 | |
Cigna
| Facility | $85.00 | $457.73 | $457.73 | |
Cigna
| Professional | $457.73 | $457.73 | $580.36 | |
United
| Professional | $440.45 | $518.17 | $518.17 |