| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $76.62 | $76.62 | $88.52 | |
Aetna
| Professional | $75.86 | $75.86 | $76.62 | |
CareSource
| Facility | $75.86 | $113.79 | $113.79 | |
Cigna
| Facility | $71.56 | $75.86 | $87.14 | |
Cigna
| Professional | $75.86 | $75.86 | $127.86 | |
United
| Professional | $75.86 | $75.86 | $102.52 |