| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $67.16 | $67.16 | $79.01 | |
Aetna
| Professional | $67.15 | $67.16 | $74.64 | |
CareSource
| Facility | $14.50 | $14.97 | $22.46 | |
Cigna
| Facility | $74.02 | $74.02 | $85.00 | |
Cigna
| Professional | $74.02 | $74.02 | $100.34 | |
United
| Professional | $66.09 | $79.01 | $84.39 |