| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $66.28 | $66.38 | $70.37 | |
Aetna
| Professional | $65.63 | $65.63 | $66.38 | |
CareSource
| Facility | $65.63 | $98.45 | $98.45 | |
Cigna
| Facility | $61.91 | $65.63 | $85.00 | |
Cigna
| Professional | $65.63 | $65.63 | $121.28 | |
United
| Professional | $65.25 | $65.63 | $76.76 |