| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.50 | $1.50 | $15.19 | |
Aetna
| Professional | $15.04 | $15.04 | $15.19 | |
CareSource
| Facility | $15.04 | $22.56 | $22.56 | |
Cigna
| Facility | $14.19 | $15.04 | $85.00 | |
Cigna
| Professional | $15.04 | $15.04 | $28.32 | |
United
| Professional | $15.04 | $15.04 | $24.06 |