| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $7.08 | $7.24 | $131.83 | |
Aetna
| Professional | $52.48 | $100.00 | $173.78 | |
CareSource
| Facility | $69.18 | $85.11 | $120.23 | |
CareSource
| Professional | $66.07 | $134.90 | $158.49 | |
Cigna
| Facility | $109.65 | $109.65 | $109.65 | |
Cigna
| Professional | $69.18 | $107.15 | $331.13 | |
United
| Professional | $53.70 | $77.62 | $114.82 |