| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.00 | $21.00 | $21.00 | |
Aetna
| Professional | $21.00 | $23.54 | $25.73 | |
CareSource
| Facility | $41.88 | $57.11 | $66.62 | |
CareSource
| Professional | $24.75 | $45.68 | $88.26 | |
Cigna
| Facility | $44.62 | $44.62 | $44.62 | |
Cigna
| Professional | $19.44 | $19.44 | $184.51 | |
United
| Professional | $18.60 | $20.03 | $38.07 |