| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $14.70 | $15.61 | $15.61 | |
CareSource
| Facility | $24.80 | $103.33 | $496.00 | |
CareSource
| Professional | $22.04 | $24.80 | $119,998.80 | |
Cigna
| Facility | $22.04 | $22.04 | $22.04 | |
Cigna
| Professional | $88.54 | $88.54 | $88.54 | |
United
| Professional | $7.72 | $8.27 | $24.80 |