| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.64 | $22.64 | $22.64 | |
Aetna
| Professional | $22.64 | $25.37 | $27.73 | |
CareSource
| Facility | $45.14 | $61.56 | $71.81 | |
CareSource
| Professional | $26.68 | $49.25 | $95.15 | |
Cigna
| Facility | $48.10 | $48.10 | $48.10 | |
Cigna
| Professional | $20.95 | $20.95 | $198.87 | |
United
| Professional | $20.05 | $23.13 | $44.67 |