| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.36 | $22.36 | $22.36 | |
Aetna
| Professional | $21.84 | $22.36 | $22.36 | |
CareSource
| Facility | $17.85 | $17.85 | $31.24 | |
Cigna
| Facility | $21.05 | $21.05 | $23.12 | |
Cigna
| Professional | $21.05 | $21.05 | $96.64 | |
United
| Professional | $21.05 | $21.05 | $26.31 |