| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.78 | $28.78 | $28.78 | |
Aetna
| Professional | $28.78 | $31.98 | $35.25 | |
CareSource
| Facility | $33.90 | $70.42 | $91.28 | |
CareSource
| Professional | $33.90 | $36.51 | $62.59 | |
Cigna
| Facility | $34.45 | $34.45 | $61.13 | |
Cigna
| Professional | $21.28 | $34.45 | $36.86 | |
United
| Professional | $19.04 | $26.02 | $43.37 |