| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.00 | $20.00 | $20.00 | |
Aetna
| Professional | $20.00 | $20.00 | $20.00 | |
CareSource
| Facility | $22.28 | $33.61 | $47.05 | |
CareSource
| Professional | $7.82 | $7.82 | $7.82 | |
Cigna
| Facility | $38.00 | $38.00 | $38.00 | |
Cigna
| Professional | $7.80 | $18.70 | $18.70 |