| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.44 | $21.44 | $21.44 | |
Aetna
| Professional | $21.23 | $21.44 | $29.15 | |
CareSource
| Facility | $21.23 | $31.85 | $31.85 | |
Cigna
| Facility | $28.21 | $28.21 | $85.00 | |
Cigna
| Professional | $28.21 | $28.21 | $40.06 | |
United
| Professional | $21.23 | $21.23 | $33.19 |