| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $36.01 | $36.01 | $36.01 | |
CareSource
| Facility | $89.10 | $101.25 | $131.25 | |
CareSource
| Professional | $81.00 | $81.00 | $72,899.27 | |
Cigna
| Professional | $63.98 | $63.98 | $63.98 |