| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,663.50 | $1,663.50 | $1,663.50 | |
CareSource
| Facility | $349.54 | $663.88 | $3,495.36 | |
CareSource
| Professional | $376.43 | $376.43 | $3,764.23 | |
United
| Professional | $1,552.60 | $2,434.25 | $4,425.89 |