| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $95.50 | $95.50 | $95.50 | |
Aetna
| Professional | $85.11 | $97.72 | $169.82 | |
CareSource
| Facility | $128.82 | $128.82 | $269.15 | |
CareSource
| Professional | $141.25 | $141.25 | $239.88 | |
Cigna
| Facility | $120.23 | $316.23 | $316.23 | |
Cigna
| Professional | $87.10 | $87.10 | $954.99 | |
United
| Facility | $117.49 | $117.49 | $204.17 | |
United
| Professional | $91.20 | $123.03 | $162.18 |