| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $48.98 | $56.23 | $64.57 | |
Aetna
| Professional | $28.18 | $51.29 | $72.44 | |
CareSource
| Facility | $35.48 | $43.65 | $60.26 | |
CareSource
| Professional | $52.48 | $57.54 | $123.03 | |
Cigna
| Facility | $57.54 | $57.54 | $57.54 | |
Cigna
| Professional | $51.29 | $51.29 | $269.15 | |
United
| Professional | $29.51 | $53.70 | $100.00 |