| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $15.74 | $15.74 | $15.74 | |
CareSource
| Facility | $22.17 | $31,499.69 | $32,999.67 | |
CareSource
| Professional | $34.27 | $34.27 | $34.27 | |
United
| Professional | $20.30 | $20.30 | $20.30 |