| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.12 | $25.12 | $25.12 | |
Aetna
| Professional | $25.12 | $28.18 | $138.04 | |
CareSource
| Facility | $30.20 | $30.20 | $35.48 | |
CareSource
| Professional | $31.62 | $31.62 | $31.62 | |
Cigna
| Facility | $45.71 | $45.71 | $45.71 | |
Cigna
| Professional | $23.99 | $35.48 | $138.04 | |
United
| Professional | $21.88 | $30.90 | $45.71 |