| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $140.00 | $140.00 | $140.00 | |
Aetna
| Professional | $140.00 | $140.00 | $140.00 | |
CareSource
| Facility | $248.14 | $372.21 | $434.24 | |
CareSource
| Professional | $256.36 | $256.36 | $439.47 | |
Cigna
| Facility | $223.29 | $223.29 | $223.29 | |
Cigna
| Professional | $163.00 | $163.00 | $223.29 | |
United
| Professional | $148.88 | $173.70 | $248.14 |