| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $123.03 | $223.87 | $223.87 | |
Aetna
| Professional | $104.71 | $120.23 | $141.25 | |
CareSource
| Facility | $204.17 | $204.17 | $204.17 | |
CareSource
| Professional | $181.97 | $181.97 | $181.97 | |
Cigna
| Facility | $125.89 | $239.88 | $446.68 | |
Cigna
| Professional | $724.44 | $724.44 | $724.44 | |
United
| Professional | $63.10 | $67.61 | $186.21 |