| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.94 | $21.94 | $24.61 | |
Aetna
| Professional | $19.30 | $22.05 | $25.33 | |
CareSource
| Facility | $19.16 | $21.78 | $40.65 | |
CareSource
| Professional | $27.00 | $27.00 | $27.00 | |
Cigna
| Facility | $38.97 | $38.97 | $38.97 | |
Cigna
| Professional | $19.00 | $27.17 | $109.12 | |
United
| Professional | $18.27 | $24.47 | $40.75 |