| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $108.80 | $119.61 | $128.00 | |
Aetna
| Professional | $39.70 | $119.61 | $119.61 | |
CareSource
| Facility | $28.21 | $28.21 | $42.32 | |
Cigna
| Facility | $108.80 | $131.35 | $131.35 | |
Cigna
| Professional | $131.35 | $131.35 | $162.56 | |
United
| Professional | $117.28 | $140.74 | $149.75 |