| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $128.82 | $234.42 | $234.42 | |
Aetna
| Professional | $109.65 | $125.89 | $147.91 | |
CareSource
| Facility | $213.80 | $213.80 | $213.80 | |
CareSource
| Professional | $186.21 | $186.21 | $186.21 | |
Cigna
| Facility | $131.83 | $251.19 | $467.74 | |
Cigna
| Professional | $758.58 | $758.58 | $758.58 | |
United
| Facility | $93.33 | $93.33 | $93.33 | |
United
| Professional | $66.07 | $70.79 | $194.98 |