| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.91 | $39.50 | $47.40 | |
Aetna
| Professional | $23.70 | $25.91 | $25.91 | |
CareSource
| Facility | $42.66 | $177.75 | $853.20 | |
CareSource
| Professional | $37.92 | $42.66 | $119,998.80 | |
Cigna
| Facility | $25.68 | $37.92 | $94.79 | |
Cigna
| Professional | $36.34 | $45.43 | $152.31 | |
United
| Professional | $13.27 | $14.22 | $31.60 |