| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $127.65 | $127.65 | $129.66 | |
Aetna
| Professional | $124.65 | $127.65 | $127.65 | |
CareSource
| Facility | $52.69 | $52.69 | $92.21 | |
Cigna
| Facility | $63.43 | $63.43 | $85.00 | |
Cigna
| Professional | $63.43 | $63.43 | $285.30 | |
United
| Professional | $121.40 | $125.15 | $150.18 |