| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $112.80 | $112.80 | $112.80 | |
Aetna
| Professional | $103.89 | $132.88 | $173.89 | |
CareSource
| Facility | $118.07 | $128.82 | $140.35 | |
CareSource
| Professional | $124.75 | $124.75 | $124.75 | |
Cigna
| Facility | $189.32 | $189.32 | $189.32 | |
Cigna
| Professional | $111.86 | $168.17 | $536.32 | |
United
| Professional | $105.40 | $154.60 | $224.97 |