| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $52.28 | $55.97 | $69.70 | |
Aetna
| Professional | $54.32 | $64.65 | $83.66 | |
Aetna
| Professional | 25 | $58.58 | $58.58 | $68.92 |
CareSource
| Facility | $66.72 | $86.15 | $113.72 | |
CareSource
| Professional | $141.97 | $159.80 | $159.80 | |
Cigna
| Facility | $84.29 | $84.29 | $84.29 | |
Cigna
| Professional | $73.22 | $116.95 | $346.12 | |
United
| Professional | $48.42 | $69.13 | $110.27 |