| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.70 | $43.75 | $52.50 | |
Aetna
| Professional | $26.25 | $28.70 | $29.75 | |
CareSource
| Facility | $38.50 | $52.50 | $61.25 | |
CareSource
| Professional | $42.00 | $42.00 | $47.25 | |
Cigna
| Facility | $28.44 | $64.41 | $104.99 | |
Cigna
| Professional | $168.70 | $168.70 | $168.70 | |
United
| Professional | $14.70 | $17.50 | $63.36 |