| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $12.89 | $12.89 | $15.16 | |
Aetna
| Professional | $12.58 | $12.89 | $12.89 | |
CareSource
| Facility | $5.86 | $6.05 | $10.59 | |
Cigna
| Facility | $12.89 | $12.89 | $85.00 | |
Cigna
| Professional | $12.89 | $12.89 | $19.25 | |
United
| Professional | $12.43 | $12.43 | $18.00 |