| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $26.36 | $45.89 | $122.78 | |
CareSource
| Facility | $36.08 | $36.08 | $36.08 | |
CareSource
| Professional | $93.34 | $98.63 | $116.56 | |
Cigna
| Facility | $50.93 | $50.93 | $50.93 | |
Cigna
| Professional | $29.63 | $66.65 | $133.75 | |
United
| Professional | $54.79 | $71.20 | $102.86 |