| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $52.00 | $52.00 | $52.00 | |
Aetna
| Professional | $38.49 | $52.00 | $52.00 | |
CareSource
| Facility | $58.85 | $82.35 | $106.75 | |
CareSource
| Professional | $39.65 | $141.43 | $141.43 | |
Cigna
| Facility | $71.06 | $71.06 | $71.06 | |
Cigna
| Professional | $21.25 | $21.25 | $294.02 | |
United
| Professional | $35.53 | $41.45 | $76.98 |