| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $10.19 | $10.84 | $12.75 | |
Aetna
| Professional | $10.19 | $10.19 | $10.58 | |
CareSource
| Facility | $17.57 | $18.14 | $31.75 | |
Cigna
| Facility | $10.19 | $10.19 | $85.00 | |
Cigna
| Professional | $10.19 | $10.19 | $28.63 | |
United
| Professional | $10.00 | $10.00 | $22.51 |