| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $30.00 | $30.00 | $30.00 | |
CareSource
| Facility | $39.49 | $59.50 | $62.50 | |
CareSource
| Professional | $42.53 | $42.53 | $42.53 | |
Cigna
| Facility | $45.00 | $60.00 | $75.00 | |
Cigna
| Professional | $45.00 | $60.00 | $66.00 |