| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $104.30 | $104.30 | $122.70 | |
Aetna
| Professional | $101.84 | $104.30 | $104.30 | |
CareSource
| Facility | $22.86 | $23.61 | $41.32 | |
Cigna
| Facility | $85.00 | $108.39 | $108.39 | |
Cigna
| Professional | $108.39 | $108.39 | $127.83 | |
United
| Professional | $79.76 | $122.70 | $122.70 |