| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $45.42 | $45.42 | $45.42 | |
Aetna
| Professional | $38.68 | $45.42 | $62.39 | |
CareSource
| Facility | $48.42 | $94.85 | $130.36 | |
CareSource
| Professional | $48.42 | $52.14 | $89.39 | |
Cigna
| Facility | $67.20 | $77.70 | $96.81 | |
Cigna
| Professional | $49.06 | $67.20 | $334.22 | |
United
| Facility | $105.88 | $105.88 | $105.88 | |
United
| Professional | $43.44 | $51.83 | $86.38 |