| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $161.54 | $161.54 | $191.92 | |
Aetna
| Professional | $191.91 | $191.92 | $211.11 | |
CareSource
| Facility | $191.92 | $287.88 | $287.88 | |
Cigna
| Facility | $144.53 | $188.55 | $188.55 | |
Cigna
| Professional | $188.55 | $188.55 | $215.95 | |
United
| Professional | $168.35 | $202.02 | $214.96 |