| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $10.48 | $10.48 | $10.76 | |
Aetna
| Professional | $10.23 | $10.48 | $10.48 | |
CareSource
| Facility | $1.95 | $2.02 | $59,999.40 | |
Cigna
| Facility | $10.48 | $10.48 | $85.00 | |
Cigna
| Professional | $10.48 | $10.48 | $15.66 | |
United
| Professional | $0.48 | $10.27 | $10.27 |