| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.15 | $0.15 | $0.15 | |
Aetna
| Professional | $0.15 | $0.15 | $0.15 | |
CareSource
| Facility | $0.34 | $0.52 | $0.68 | |
CareSource
| Professional | $0.50 | $0.50 | $0.50 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $0.28 | $0.28 | $1.05 |