| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.82 | $17.82 | $404.41 | |
Aetna
| Professional | $16.52 | $27.10 | $458.50 | |
CareSource
| Facility | $19.09 | $22.57 | $30.21 | |
CareSource
| Professional | $20.05 | $20.05 | $20.05 | |
Cigna
| Facility | $29.12 | $29.12 | $29.12 | |
Cigna
| Professional | $13.39 | $82.61 | $482.07 | |
United
| Professional | $67.30 | $185.18 | $372.00 |