| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.59 | $132.30 | $300.60 | |
Aetna
| Professional | $26.32 | $33.52 | $36.86 | |
CareSource
| Facility | $35.09 | $47.37 | $57.90 | |
CareSource
| Professional | $35.09 | $47.37 | $47.37 | |
Cigna
| Facility | $28.51 | $79.05 | $105.27 | |
Cigna
| Professional | $18.45 | $18.45 | $169.13 | |
United
| Professional | $15.79 | $21.05 | $64.98 |