| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $26.56 | $26.56 | $26.56 | |
Aetna
| Professional | $26.56 | $26.56 | $26.56 | |
CareSource
| Facility | $39.90 | $59.85 | $59.85 | |
Cigna
| Facility | $45.89 | $45.89 | $45.89 | |
Cigna
| Professional | $31.89 | $31.89 | $192.32 | |
United
| Professional | $28.33 | $38.01 | $58.91 |