| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $86.94 | $86.94 | $88.16 | |
Aetna
| Professional | $87.28 | $87.28 | $88.16 | |
CareSource
| Facility | $87.28 | $130.91 | $130.91 | |
Cigna
| Facility | $82.34 | $87.28 | $89.60 | |
Cigna
| Professional | $87.28 | $87.28 | $129.97 | |
United
| Professional | $56.73 | $87.28 | $105.94 |