| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $107.15 | $169.82 | $263.03 | |
CareSource
| Professional | $100.00 | $100.00 | $100.00 | |
Cigna
| Professional | $91.20 | $204.17 | $1,348.96 | |
United
| Professional | $97.72 | $177.83 | $338.84 |