| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.69 | $19.69 | $47.14 | |
Aetna
| Professional | $19.69 | $32.09 | $39.13 | |
CareSource
| Facility | $21.75 | $22.46 | $39.31 | |
Cigna
| Facility | $41.64 | $41.64 | $85.00 | |
Cigna
| Professional | $41.64 | $41.64 | $121.61 | |
United
| Professional | $45.73 | $47.14 | $47.14 |