| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $123.03 | $295.12 | $295.12 | |
Aetna
| Professional | $112.20 | $131.83 | $158.49 | |
CareSource
| Facility | $269.15 | $269.15 | $269.15 | |
CareSource
| Professional | $239.88 | $239.88 | $239.88 | |
Cigna
| Facility | $144.54 | $316.23 | $446.68 | |
Cigna
| Professional | $954.99 | $954.99 | $954.99 | |
United
| Facility | $120.23 | $120.23 | $120.23 | |
United
| Professional | $67.61 | $69.18 | $186.21 |