| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $141.54 | $214.54 | $275.95 | |
CareSource
| Professional | $162.47 | $162.47 | $162.47 | |
Cigna
| Professional | $162.47 | $279.73 | $693.79 | |
United
| Professional | $185.86 | $267.27 | $444.49 |