| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.90 | $31.11 | $84.96 | |
Aetna
| Professional | $28.61 | $28.61 | $31.11 | |
CareSource
| Facility | $28.61 | $42.92 | $42.92 | |
Cigna
| Facility | $26.99 | $28.61 | $85.00 | |
Cigna
| Professional | $28.61 | $28.61 | $184.49 | |
United
| Professional | $28.61 | $28.61 | $167.97 |