| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $24.27 | $37.00 | $44.40 | |
Aetna
| Professional | $22.20 | $24.27 | $25.16 | |
CareSource
| Facility | $39.96 | $166.50 | $799.20 | |
CareSource
| Professional | $35.52 | $39.96 | $119,998.80 | |
Cigna
| Facility | $24.05 | $35.52 | $88.79 | |
Cigna
| Professional | $142.66 | $142.66 | $142.66 | |
United
| Professional | $13.32 | $16.45 | $59.54 |