| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $73.81 | $73.81 | $73.81 | |
Aetna
| Professional | $73.81 | $73.81 | $84.89 | |
CareSource
| Facility | $73.81 | $110.73 | $110.73 | |
Cigna
| Facility | $66.05 | $72.52 | $72.52 | |
Cigna
| Professional | $72.52 | $72.52 | $98.68 | |
United
| Professional | $73.81 | $77.70 | $118.11 |