| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $56.23 | $63.10 | $91.20 | |
CareSource
| Facility | $77.62 | $77.62 | $93.33 | |
CareSource
| Professional | $81.28 | $81.28 | $81.28 | |
Cigna
| Facility | $112.20 | $112.20 | $112.20 | |
Cigna
| Professional | $61.66 | $93.33 | $338.84 | |
United
| Professional | $56.23 | $85.11 | $128.82 |