| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $35.09 | $35.09 | $35.09 | |
Aetna
| Professional | $35.09 | $51.59 | $79.45 | |
CareSource
| Facility | $91.40 | $106.64 | $125.24 | |
Cigna
| Facility | $97.84 | $97.84 | $97.84 | |
Cigna
| Professional | $0.09 | $0.09 | $402.42 | |
United
| Professional | $45.12 | $71.34 | $116.89 |