| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15.85 | $15.85 | $15.85 | |
Aetna
| Professional | $18.20 | $22.91 | $33.11 | |
CareSource
| Facility | $30.90 | $30.90 | $30.90 | |
CareSource
| Professional | $27.54 | $27.54 | $27.54 | |
United
| Professional | $75.86 | $75.86 | $87.10 |