| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $24.77 | $24.77 | $24.77 | |
Aetna
| Professional | $24.77 | $26.93 | $30.47 | |
CareSource
| Facility | $56.95 | $75.78 | $88.41 | |
Cigna
| Facility | $61.03 | $61.03 | $61.03 | |
Cigna
| Professional | $34.94 | $34.94 | $248.37 | |
United
| Professional | $25.21 | $30.31 | $39.97 |