| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $67.31 | $72.38 | $79.02 | |
Aetna
| Professional | $66.64 | $66.64 | $72.38 | |
CareSource
| Facility | $66.64 | $99.96 | $99.96 | |
Cigna
| Facility | $62.87 | $66.64 | $90.77 | |
Cigna
| Professional | $66.64 | $66.64 | $118.46 | |
United
| Professional | $66.64 | $66.64 | $111.87 |