| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $74.09 | $81.73 | $96.04 | |
CareSource
| Facility | $10.26 | $76.51 | $115.66 | |
CareSource
| Professional | $10.11 | $82.40 | $109.88 | |
Cigna
| Facility | $96.42 | $96.42 | $168.44 | |
Cigna
| Professional | $96.42 | $96.42 | $106.80 | |
United
| Professional | $55.15 | $78.31 | $112.34 |