| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4.04 | $4.04 | $4.04 | |
Aetna
| Professional | $2.86 | $4.04 | $6.15 | |
CareSource
| Facility | $0.09 | $1.83 | $2.49 | |
CareSource
| Professional | $0.08 | $0.08 | $0.08 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $1.83 | $2.98 | $2.98 |