| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.31 | $30.31 | $35.40 | |
Aetna
| Professional | $34.58 | $35.40 | $35.40 | |
CareSource
| Facility | $2.50 | $2.59 | $4.53 | |
Cigna
| Facility | $35.40 | $35.40 | $85.00 | |
Cigna
| Professional | $35.40 | $35.40 | $52.91 | |
United
| Professional | $34.72 | $34.72 | $53.03 |