| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $50.71 | $50.71 | $50.71 | |
Aetna
| Professional | $41.88 | $48.53 | $53.80 | |
CareSource
| Facility | $63.80 | $125.29 | $171.78 | |
CareSource
| Professional | $63.80 | $68.70 | $111.37 | |
Cigna
| Facility | $53.85 | $53.85 | $112.17 | |
Cigna
| Professional | $39.31 | $53.85 | $470.14 | |
United
| Professional | $40.47 | $51.14 | $84.51 |