| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $0.50 | $0.50 | $0.50 | |
CareSource
| Facility | $20.58 | $20.58 | $20.58 | |
CareSource
| Professional | $18.29 | $18.29 | $18.29 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $1.21 | $1.21 | $1.21 |