| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $83.47 | $83.47 | $83.47 | |
CareSource
| Facility | $102.06 | $102.06 | $59,999.40 | |
CareSource
| Professional | $90.72 | $90.72 | $72,899.27 | |
Cigna
| Professional | $385.20 | $385.20 | $385.20 |