| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.06 | $126.63 | $1,400.00 | |
Aetna
| Professional | $29.92 | $45.34 | $195.18 | |
CareSource
| Facility | $31.87 | $35.11 | $50.98 | |
CareSource
| Professional | $34.01 | $34.01 | $34.01 | |
Cigna
| Facility | $51.10 | $51.10 | $51.10 | |
Cigna
| Professional | $34.01 | $127.09 | $395.82 | |
United
| Professional | $117.41 | $189.88 | $350.23 |