| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $42.28 | $52.85 | $63.42 | |
Aetna
| Professional | $42.28 | $42.28 | $42.28 | |
CareSource
| Facility | $57.08 | $152.21 | $1,141.56 | |
CareSource
| Professional | $50.74 | $57.08 | $119,998.80 | |
Cigna
| Facility | $34.35 | $50.74 | $50.74 | |
Cigna
| Professional | $48.57 | $60.71 | $203.79 | |
United
| Professional | $16.29 | $18.57 | $63.18 |