| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $413.49 | $413.49 | $413.49 | |
Aetna
| Professional | $413.49 | $413.49 | $460.23 | |
CareSource
| Facility | $554.74 | $1,138.36 | $1,475.67 | |
CareSource
| Professional | $548.11 | $597.41 | $1,024.13 | |
Cigna
| Facility | $528.74 | $528.74 | $1,029.38 | |
Cigna
| Professional | $385.98 | $528.74 | $4,314.43 | |
United
| Professional | $420.68 | $558.92 | $732.46 |