| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $140.43 | $140.43 | $142.40 | |
Aetna
| Professional | $140.99 | $140.99 | $142.40 | |
CareSource
| Facility | $140.99 | $211.49 | $211.49 | |
Cigna
| Facility | $133.01 | $140.99 | $155.51 | |
Cigna
| Professional | $140.99 | $140.99 | $264.16 | |
United
| Professional | $91.64 | $156.76 | $184.42 |