| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.14 | $99.00 | $170.10 | |
Aetna
| Professional | $16.21 | $17.22 | $17.22 | |
CareSource
| Facility | $20.26 | $25.33 | $30.39 | |
CareSource
| Professional | $20.26 | $27.35 | $27.35 | |
Cigna
| Facility | $47.24 | $47.24 | $47.24 | |
Cigna
| Professional | $35.11 | $37.96 | $128.53 | |
United
| Professional | $11.14 | $20.26 | $45.62 |