| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $69.22 | $89.88 | $105.28 | |
Aetna
| Professional | $69.20 | $69.22 | $155.55 | |
CareSource
| Facility | $104.44 | $104.44 | $44,999.55 | |
Cigna
| Facility | $69.22 | $76.14 | $76.14 | |
Cigna
| Professional | $76.14 | $76.14 | $103.42 | |
United
| Professional | $77.36 | $81.43 | $98.78 |