| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.57 | $1.57 | $10.93 | |
CareSource
| Facility | $36.00 | $36.00 | $36.00 | |
CareSource
| Professional | $15.60 | $15.60 | $15.60 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $10.60 | $10.60 | $10.60 | |
United
| Professional | $16.80 | $25.20 | $37.20 |