| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $65.26 | $75.05 | $75.80 | |
Aetna
| Professional | $64.62 | $64.62 | $75.80 | |
CareSource
| Facility | $64.62 | $96.93 | $96.93 | |
Cigna
| Facility | $60.96 | $64.62 | $86.22 | |
Cigna
| Professional | $64.62 | $64.62 | $131.68 | |
United
| Professional | $64.62 | $64.62 | $157.71 |