| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.84 | $14.84 | $14.84 | |
Aetna
| Professional | $19.00 | $19.57 | $24.37 | |
CareSource
| Facility | $22.41 | $22.41 | $22.41 | |
CareSource
| Professional | $22.41 | $22.41 | $22.41 | |
Cigna
| Facility | $38.77 | $38.77 | $38.77 | |
Cigna
| Professional | $22.00 | $41.19 | $165.28 | |
United
| Professional | $26.43 | $42.37 | $58.92 |