| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.13 | $14.13 | $14.13 | |
Aetna
| Professional | $14.13 | $18.20 | $23.99 | |
CareSource
| Facility | $19.05 | $19.05 | $54.95 | |
CareSource
| Professional | $19.05 | $19.05 | $19.05 | |
Cigna
| Facility | $70.79 | $70.79 | $70.79 | |
Cigna
| Professional | $21.88 | $194.98 | $194.98 | |
United
| Professional | $8.91 | $24.55 | $85.11 |