| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.11 | $100.11 | $100.11 | |
Aetna
| Professional | $100.11 | $100.11 | $109.72 | |
CareSource
| Facility | $132.69 | $275.60 | $361.67 | |
CareSource
| Professional | $132.69 | $142.91 | $244.98 | |
Cigna
| Facility | $170.15 | $170.15 | $279.14 | |
Cigna
| Professional | $124.21 | $170.15 | $1,169.96 | |
United
| Professional | $101.84 | $142.27 | $169.74 |