| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $49.65 | $62.16 | $62.16 | |
CareSource
| Professional | $20.57 | $20.57 | $20.57 | |
Cigna
| Facility | 26 | $46.16 | $46.16 | $46.16 |
Cigna
| Professional | $30.75 | $41.07 | $108.11 | |
United
| Professional | $32.33 | $52.85 | $110.11 |