| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $72.70 | $72.70 | $83.69 | |
Aetna
| Professional | $64.80 | $75.93 | $85.68 | |
CareSource
| Facility | $57.49 | $65.33 | $121.96 | |
CareSource
| Professional | $90.28 | $90.28 | $90.28 | |
Cigna
| Facility | $116.71 | $116.71 | $116.71 | |
Cigna
| Professional | $36.00 | $71.70 | $278.38 | |
United
| Professional | $60.56 | $95.99 | $137.72 |