| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $450.00 | $450.00 | $450.00 | |
Aetna
| Professional | $450.00 | $450.00 | $450.00 | |
CareSource
| Facility | $394.60 | $414.84 | $710.28 | |
CareSource
| Professional | $335.41 | $434.06 | $607.67 | |
Cigna
| Facility | $517.50 | $517.50 | $517.50 | |
Cigna
| Professional | $2,169.00 | $2,169.00 | $2,169.00 | |
United
| Professional | $372.15 | $501.60 | $779.46 |