| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $72.44 | $72.44 | $72.44 | |
Aetna
| Professional | $64.57 | $72.44 | $125.89 | |
CareSource
| Facility | $100.00 | $100.00 | $204.17 | |
CareSource
| Professional | $107.15 | $107.15 | $181.97 | |
Cigna
| Facility | $97.72 | $239.88 | $239.88 | |
Cigna
| Professional | $72.44 | $72.44 | $724.44 | |
United
| Facility | $89.13 | $89.13 | $154.88 | |
United
| Professional | $69.18 | $93.33 | $123.03 |