| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $33.68 | $34.68 | $40.54 | |
Aetna
| Professional | $23.34 | $33.67 | $72.54 | |
Aetna
| Professional | 25 | $50.51 | $50.51 | $50.51 |
Ambetter
| Professional | $36.65 | $43.13 | $49.84 | |
CareSource
| Facility | $28.57 | $39.07 | $47.14 | |
CareSource
| Professional | $29.03 | $38.47 | $69.79 | |
Cigna
| Professional | $17.85 | $28.57 | $28.57 | |
Qualchoice
| Professional | $43.70 | $49.60 | $57.32 | |
United
| Professional | $29.76 | $37.54 | $48.02 |