| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.50 | $125.50 | $147.65 | |
Aetna
| Professional | $125.50 | $125.50 | $138.05 | |
CareSource
| Facility | $71.66 | $73.98 | $110.99 | |
Cigna
| Facility | $95.82 | $137.94 | $137.94 | |
Cigna
| Professional | $137.94 | $137.94 | $400.69 | |
United
| Professional | $147.65 | $147.65 | $188.53 |