| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $381.64 | $381.64 | $388.70 | |
Aetna
| Professional | $384.85 | $384.85 | $388.70 | |
CareSource
| Facility | $384.85 | $577.28 | $577.28 | |
Cigna
| Facility | $363.06 | $381.50 | $384.85 | |
Cigna
| Professional | $384.85 | $384.85 | $691.84 | |
United
| Professional | $384.85 | $407.94 | $435.79 |