| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $105.88 | $105.88 | $105.88 | |
Aetna
| Professional | $98.70 | $101.33 | $105.88 | |
CareSource
| Facility | $137.19 | $276.67 | $358.65 | |
CareSource
| Professional | $133.21 | $147.75 | $253.28 | |
Cigna
| Facility | $149.11 | $149.11 | $247.34 | |
Cigna
| Professional | $108.85 | $149.11 | $1,006.90 | |
United
| Professional | $78.42 | $103.88 | $160.38 |