| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.84 | $29.84 | $29.84 | |
Aetna
| Professional | $27.73 | $32.71 | $64.23 | |
CareSource
| Facility | $27.55 | $30.31 | $41.33 | |
CareSource
| Professional | $27.55 | $35.24 | $63.87 | |
Cigna
| Facility | $33.47 | $33.47 | $33.47 | |
Cigna
| Professional | $27.04 | $45.45 | $113.56 | |
United
| Professional | $24.75 | $34.86 | $56.89 |