| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $64.31 | $360.00 | $360.00 | |
Aetna
| Professional | $38.59 | $42.19 | $43.73 | |
CareSource
| Facility | $51.45 | $69.45 | $84.89 | |
CareSource
| Professional | $51.45 | $69.45 | $69.45 | |
Cigna
| Facility | $41.80 | $127.48 | $412.15 | |
Cigna
| Professional | $247.99 | $247.99 | $247.99 | |
United
| Professional | $21.61 | $25.73 | $74.59 |