| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $49.62 | $49.62 | $58.38 | |
Aetna
| Professional | $48.46 | $49.62 | $49.62 | |
CareSource
| Facility | $19.52 | $20.14 | $35.26 | |
Cigna
| Facility | $49.62 | $49.62 | $85.00 | |
Cigna
| Professional | $49.62 | $49.62 | $74.14 | |
United
| Professional | $48.65 | $48.65 | $58.38 |