| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.57 | $83.66 | $83.66 | |
Aetna
| Professional | $30.57 | $30.57 | $42.71 | |
CareSource
| Facility | $46.13 | $61,249.40 | $122,362.78 | |
Cigna
| Facility | $33.71 | $33.71 | $85.00 | |
Cigna
| Professional | $33.71 | $33.71 | $45.68 | |
United
| Professional | $22.21 | $35.97 | $43.63 |