| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3.98 | $3.98 | $3.98 | |
Aetna
| Professional | $2.00 | $3.98 | $4.07 | |
CareSource
| Facility | $0.09 | $0.09 | $0.09 | |
CareSource
| Professional | $0.08 | $0.08 | $0.08 | |
Cigna
| Facility | $64.57 | $64.57 | $64.57 | |
Cigna
| Professional | $2.95 | $2.95 | $2.95 |