| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3.00 | $3.00 | $3.00 | |
Aetna
| Professional | $3.00 | $3.00 | $3.00 | |
CareSource
| Facility | $23.76 | $29.70 | $34.65 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $8.50 | $8.50 | $20.59 |