| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $13.91 | $13.91 | $16.37 | |
Aetna
| Professional | $13.59 | $13.91 | $13.91 | |
CareSource
| Facility | $4.21 | $44,999.55 | $69,999.30 | |
Cigna
| Facility | $13.91 | $13.91 | $13.91 | |
Cigna
| Professional | $13.91 | $13.91 | $20.79 | |
United
| Professional | $13.64 | $13.64 | $16.37 |