| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.03 | $35.36 | $51.96 | |
Aetna
| Professional | $14.40 | $23.69 | $39.89 | |
Aetna
| Professional | CQ | $55.23 | $55.23 | $55.23 |
BCBS
| Facility | $33.50 | $33.50 | $43.55 | |
BCBS
| Professional | $43.33 | $43.33 | $43.33 | |
CareSource
| Facility | $30.51 | $32.42 | $33.56 | |
Cigna
| Facility | $60.00 | $70.00 | $85.00 | |
Cigna
| Professional | $30.03 | $54.94 | $114.99 | |
United
| Professional | $27.30 | $30.81 | $39.07 |