| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $156.66 | $156.66 | $156.66 | |
Aetna
| Professional | $132.97 | $149.94 | $156.66 | |
CareSource
| Facility | $197.12 | $379.08 | $530.71 | |
CareSource
| Professional | $191.52 | $212.28 | $328.32 | |
Cigna
| Facility | $170.96 | $170.96 | $352.74 | |
Cigna
| Professional | $124.80 | $124.80 | $1,478.44 | |
United
| Professional | $114.40 | $151.30 | $252.16 |