| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $48.00 | $10,028.48 | $10,028.48 | |
Aetna
| Professional | $47.53 | $48.00 | $54.71 | |
CareSource
| Facility | $47.53 | $71.30 | $71.30 | |
Cigna
| Facility | $44.83 | $47.52 | $99.07 | |
Cigna
| Professional | $47.52 | $47.52 | $90.08 | |
United
| Professional | $47.53 | $47.53 | $115.10 |