| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.78 | $14.78 | $14.78 | |
Aetna
| Professional | $14.78 | $16.55 | $18.11 | |
CareSource
| Facility | $29.47 | $40.19 | $46.88 | |
CareSource
| Professional | $17.41 | $32.15 | $62.13 | |
Cigna
| Facility | $31.39 | $31.39 | $31.39 | |
Cigna
| Professional | $10.93 | $12.04 | $12.04 | |
United
| Professional | $13.10 | $15.11 | $26.79 |