| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $33.88 | $33.88 | $46.77 | |
Aetna
| Professional | $32.36 | $46.77 | $66.07 | |
CareSource
| Facility | $37.15 | $37.15 | $44.67 | |
CareSource
| Professional | $39.81 | $39.81 | $39.81 | |
Cigna
| Facility | $57.54 | $57.54 | $57.54 | |
Cigna
| Professional | $39.81 | $66.07 | $239.88 | |
United
| Facility | $104.71 | $104.71 | $104.71 | |
United
| Professional | $30.20 | $45.71 | $74.13 |