| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $61.52 | $62.58 | $62.58 | |
Aetna
| Professional | $57.90 | $60.08 | $61.52 | |
CareSource
| Facility | $49.23 | $49.23 | $73.84 | |
CareSource
| Professional | $47.68 | $47.68 | $49.23 | |
Cigna
| Facility | $61.52 | $85.00 | $85.00 | |
Cigna
| Professional | $61.52 | $61.52 | $61.52 | |
United
| Professional | $60.32 | $60.32 | $72.38 |