| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $16.98 | $16.98 | $16.98 | |
Aetna
| Professional | $15.85 | $19.05 | $56.23 | |
CareSource
| Facility | $19.05 | $19.05 | $22.39 | |
CareSource
| Professional | $19.95 | $19.95 | $19.95 | |
Cigna
| Facility | $28.84 | $28.84 | $28.84 | |
Cigna
| Professional | $18.20 | $44.67 | $100.00 | |
United
| Professional | $14.13 | $19.50 | $28.18 |