| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.70 | $22.62 | $22.84 | |
Aetna
| Professional | $21.48 | $21.48 | $22.84 | |
CareSource
| Facility | $21.48 | $32.22 | $32.22 | |
Cigna
| Facility | $20.27 | $21.48 | $85.00 | |
Cigna
| Professional | $21.48 | $21.48 | $43.96 | |
United
| Professional | $21.48 | $21.48 | $63.20 |