| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $6.53 | $6.53 | $6.53 | |
CareSource
| Facility | $9.19 | $31,499.69 | $32,999.67 | |
CareSource
| Professional | $14.21 | $14.21 | $14.21 | |
United
| Professional | $8.65 | $8.65 | $8.65 |