| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $63.09 | $64.31 | $115.66 | |
Aetna
| Professional | $63.09 | $63.68 | $64.31 | |
CareSource
| Facility | $63.68 | $95.52 | $95.52 | |
Cigna
| Facility | $60.08 | $63.68 | $113.87 | |
Cigna
| Professional | $63.68 | $63.68 | $102.96 | |
United
| Professional | $63.68 | $63.68 | $137.97 |