| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.76 | $1.76 | $1.76 | |
Aetna
| Professional | $1.76 | $1.76 | $1.76 | |
CareSource
| Facility | $44,999.55 | $59,999.40 | $69,999.30 | |
CareSource
| Professional | $35,999.64 | $35,999.64 | $41,999.58 | |
Cigna
| Professional | $10.19 | $10.19 | $10.19 | |
United
| Facility | $0.04 | $0.04 | $0.04 | |
United
| Professional | $3.13 | $4.17 | $4.17 |