| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $10.36 | $10.36 | $10.36 | |
Aetna
| Professional | $10.36 | $15.24 | $23.47 | |
CareSource
| Facility | $27.17 | $31.70 | $36.99 | |
Cigna
| Facility | $28.90 | $28.90 | $28.90 | |
Cigna
| Professional | $20.35 | $20.35 | $118.86 | |
United
| Professional | $12.36 | $18.13 | $34.52 |