| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $16.20 | $16.20 | $16.20 | |
Aetna
| Professional | $16.20 | $18.14 | $19.85 | |
CareSource
| Facility | $29.38 | $39.65 | $48.48 | |
CareSource
| Professional | $29.38 | $68.12 | $68.12 | |
Cigna
| Facility | $34.43 | $34.43 | $34.43 | |
Cigna
| Professional | $15.00 | $15.00 | $142.13 | |
United
| Professional | $14.35 | $14.71 | $29.38 |