| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $243.36 | $243.36 | $243.36 | |
Aetna
| Professional | $15.74 | $243.36 | $349.75 | |
CareSource
| Facility | $45.06 | $48.79 | $67.59 | |
CareSource
| Professional | $46.68 | $48.79 | $74.20 | |
Cigna
| Facility | $318.39 | $318.39 | $318.39 | |
Cigna
| Professional | $270.64 | $270.64 | $318.39 | |
United
| Professional | $15.45 | $23.71 | $1,009.15 |