| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $350.00 | $350.00 | $350.00 | |
Aetna
| Professional | $350.00 | $350.00 | $350.00 | |
CareSource
| Facility | $365.58 | $498.51 | $498.51 | |
CareSource
| Professional | $398.81 | $398.81 | $398.81 | |
Cigna
| Facility | $70.00 | $70.00 | $70.00 |