| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $24.95 | $24.95 | $29.35 | |
Aetna
| Professional | $24.95 | $24.95 | $24.95 | |
CareSource
| Facility | $19.57 | $19.57 | $59,999.40 | |
CareSource
| Professional | $35,999.64 | $35,999.64 | $41,999.58 | |
Cigna
| Facility | $27.68 | $27.68 | $85.00 | |
Cigna
| Professional | $27.68 | $27.68 | $106.04 | |
United
| Professional | $29.35 | $29.35 | $37.47 |