| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $607.62 | $607.62 | $607.62 | |
Aetna
| Professional | $452.99 | $607.62 | $607.62 | |
CareSource
| Facility | $1,061.39 | $1,061.39 | $1,093.33 | |
CareSource
| Professional | $1,061.39 | $1,061.39 | $1,061.39 | |
Cigna
| Facility | $607.01 | $607.01 | $874.55 | |
Cigna
| Professional | $443.12 | $607.00 | $854.06 | |
United
| Professional | $323.08 | $492.44 | $658.72 |