| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.89 | $30.89 | $30.89 | |
Aetna
| Professional | $20.03 | $23.16 | $30.89 | |
CareSource
| Facility | $30.88 | $34.86 | $50.95 | |
CareSource
| Professional | $30.88 | $33.97 | $71.59 | |
Cigna
| Facility | $38.61 | $38.61 | $38.61 | |
Cigna
| Professional | $27.68 | $62.87 | $116.06 | |
United
| Professional | $22.56 | $30.88 | $46.73 |