| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $43.33 | $43.33 | $43.33 | |
Aetna
| Professional | $43.33 | $46.45 | $120.00 | |
CareSource
| Facility | $51.09 | $51.09 | $60.39 | |
CareSource
| Professional | $53.68 | $53.68 | $53.68 | |
Cigna
| Facility | $55.80 | $55.80 | $55.80 | |
Cigna
| Professional | $40.95 | $53.67 | $99.91 | |
United
| Professional | $34.27 | $50.08 | $79.08 |