| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $10.96 | $10.96 | $10.96 | |
Aetna
| Professional | $12.88 | $18.20 | $125.89 | |
CareSource
| Facility | $20.42 | $20.42 | $20.42 | |
CareSource
| Professional | $20.42 | $20.42 | $20.42 | |
Cigna
| Facility | $181.97 | $181.97 | $181.97 | |
Cigna
| Professional | $19.05 | $512.86 | $512.86 | |
United
| Professional | $23.99 | $123.03 | $213.80 |