| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $22.26 | $22.26 | $22.26 |
Aetna
| Professional | $36.34 | $53.28 | $53.59 | |
Aetna
| Professional | 26 | $20.44 | $22.26 | $25.99 |
CareSource
| Professional | $24.01 | $24.01 | $24.01 | |
Cigna
| Facility | 26 | $24.30 | $24.30 | $24.30 |
Cigna
| Professional | $42.96 | $61.03 | $121.21 | |
Cigna
| Professional | 26 | $19.91 | $29.82 | $78.28 |
United
| Professional | $30.62 | $42.67 | $62.73 | |
United
| Professional | 26 | $16.12 | $23.69 | $34.27 |