| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15.77 | $15.77 | $15.77 | |
Aetna
| Professional | $15.03 | $16.09 | $22.01 | |
CareSource
| Facility | $27.21 | $38.54 | $95.16 | |
CareSource
| Professional | $30.11 | $94.44 | $103.81 | |
Cigna
| Facility | $44.24 | $54.94 | $54.94 | |
Cigna
| Professional | $40.11 | $54.94 | $140.31 | |
United
| Professional | $16.70 | $22.43 | $45.16 |