| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $32.54 | $37.36 | $37.36 | |
CareSource
| Facility | $52.76 | $65.95 | $76.95 | |
CareSource
| Professional | $52.76 | $52.76 | $59.36 | |
Cigna
| Facility | $52.76 | $52.76 | $52.76 | |
Cigna
| Professional | $23.12 | $23.12 | $23.12 | |
United
| Professional | $12.54 | $15.60 | $53.71 |