| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $83.96 | $83.96 | $83.96 | |
Aetna
| Professional | $75.87 | $83.96 | $98.61 | |
CareSource
| Facility | $89.03 | $145.06 | $149.19 | |
CareSource
| Professional | $81.36 | $91.18 | $124.34 | |
Cigna
| Facility | $95.46 | $95.46 | $95.46 | |
Cigna
| Professional | $77.80 | $96.33 | $192.37 | |
United
| Professional | $70.17 | $97.85 | $151.88 |