| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $77.20 | $77.20 | $77.20 | |
Aetna
| Professional | $61.17 | $73.90 | $77.87 | |
CareSource
| Facility | $97.15 | $182.00 | $261.56 | |
CareSource
| Professional | $84.12 | $104.62 | $144.19 | |
Cigna
| Facility | $75.09 | $75.09 | $155.93 | |
Cigna
| Professional | $54.82 | $75.09 | $653.54 | |
United
| Professional | $50.24 | $74.56 | $124.27 |