| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $129.58 | $129.58 | $130.87 | |
Aetna
| Professional | $129.47 | $130.77 | $177.81 | |
CareSource
| Facility | $129.47 | $194.22 | $194.22 | |
Cigna
| Facility | $122.15 | $129.47 | $129.50 | |
Cigna
| Professional | $129.47 | $129.47 | $240.36 | |
United
| Professional | $125.60 | $129.47 | $147.18 |