| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.59 | $28.59 | $28.59 | |
Aetna
| Professional | $26.65 | $27.36 | $31.64 | |
CareSource
| Facility | $37.06 | $74.70 | $96.85 | |
CareSource
| Professional | $35.97 | $39.90 | $68.41 | |
Cigna
| Facility | $33.22 | $33.22 | $66.80 | |
Cigna
| Professional | $24.25 | $33.22 | $271.94 | |
United
| Professional | $21.18 | $28.06 | $46.01 |