| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $117.19 | $117.19 | $118.53 | |
Aetna
| Professional | $117.36 | $117.36 | $118.53 | |
CareSource
| Facility | $117.36 | $176.04 | $176.04 | |
Cigna
| Facility | $110.72 | $116.47 | $117.36 | |
Cigna
| Professional | $117.36 | $117.36 | $211.84 | |
United
| Professional | $113.84 | $117.36 | $136.94 |