| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $127.53 | $184.00 | $184.00 | |
Aetna
| Professional | $182.18 | $184.00 | $191.29 | |
CareSource
| Facility | $182.18 | $182.18 | $273.27 | |
CareSource
| Professional | $182.18 | $182.18 | $422.39 | |
Cigna
| Facility | $171.87 | $425.00 | $425.00 | |
Cigna
| Professional | $182.18 | $182.18 | $182.18 | |
United
| Professional | $182.18 | $182.18 | $560.97 |