| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.30 | $19.30 | $19.30 | |
Aetna
| Professional | $17.98 | $18.47 | $19.30 | |
CareSource
| Facility | $25.03 | $50.44 | $65.38 | |
CareSource
| Professional | $24.28 | $26.96 | $46.21 | |
Cigna
| Facility | $21.38 | $21.38 | $45.13 | |
Cigna
| Professional | $15.61 | $21.38 | $183.64 | |
United
| Professional | $15.50 | $19.64 | $31.06 |