| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $32.32 | $32.32 | $32.32 | |
Aetna
| Professional | $24.00 | $30.39 | $32.32 | |
CareSource
| Facility | $40.67 | $77.97 | $109.50 | |
CareSource
| Professional | $40.67 | $43.80 | $73.69 | |
Cigna
| Facility | $31.92 | $31.92 | $71.95 | |
Cigna
| Professional | $23.30 | $31.92 | $266.50 | |
United
| Professional | $20.81 | $31.21 | $52.02 |