| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15.12 | $15.12 | $15.12 | |
Aetna
| Professional | $15.12 | $22.22 | $34.22 | |
CareSource
| Facility | $39.28 | $45.83 | $53.94 | |
Cigna
| Facility | $42.14 | $42.14 | $42.14 | |
Cigna
| Professional | $16.14 | $16.14 | $173.33 | |
United
| Professional | $17.94 | $28.41 | $50.34 |