| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $36.67 | $36.67 | $36.67 | |
Aetna
| Professional | $36.67 | $40.75 | $44.92 | |
CareSource
| Facility | $43.21 | $89.75 | $116.34 | |
CareSource
| Professional | $43.21 | $46.54 | $79.78 | |
Cigna
| Facility | $39.94 | $39.94 | $77.90 | |
Cigna
| Professional | $33.95 | $39.94 | $321.58 | |
United
| Professional | $24.26 | $33.31 | $55.28 |