| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $41.69 | $63.10 | $63.10 | |
Aetna
| Professional | $41.69 | $41.69 | $41.69 | |
CareSource
| Facility | $57.54 | $57.54 | $57.54 | |
CareSource
| Professional | $51.29 | $51.29 | $51.29 | |
Cigna
| Facility | $35.48 | $67.61 | $67.61 | |
Cigna
| Professional | $48.98 | $204.17 | $204.17 | |
United
| Facility | $25.12 | $25.12 | $25.12 | |
United
| Professional | $16.22 | $17.78 | $36.31 |