| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $28.63 | $48.46 | $106.04 | |
CareSource
| Facility | $39.11 | $39.11 | $42.62 | |
CareSource
| Professional | $80.41 | $85.58 | $101.14 | |
Cigna
| Facility | $54.53 | $54.53 | $54.53 | |
Cigna
| Professional | $30.58 | $61.35 | $117.67 | |
United
| Professional | $51.73 | $66.13 | $98.25 |