| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $135.38 | $135.38 | $135.38 | |
Aetna
| Professional | $100.93 | $135.38 | $135.38 | |
CareSource
| Facility | $236.42 | $236.42 | $243.60 | |
CareSource
| Professional | $236.42 | $236.42 | $236.42 | |
Cigna
| Facility | $135.22 | $135.22 | $194.87 | |
Cigna
| Professional | $98.72 | $135.22 | $190.30 | |
United
| Professional | $71.98 | $109.72 | $146.43 |