| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $17.48 | $30.50 | $103.59 | |
CareSource
| Facility | $24.10 | $24.10 | $24.10 | |
CareSource
| Professional | $79.27 | $83.53 | $98.72 | |
Cigna
| Facility | $33.93 | $33.93 | $33.93 | |
Cigna
| Professional | $19.73 | $53.74 | $109.93 | |
United
| Professional | $48.24 | $57.89 | $88.67 |