| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.20 | $19.20 | $19.20 | |
Aetna
| Professional | $19.19 | $19.20 | $21.12 | |
CareSource
| Facility | $9.76 | $10.08 | $15.12 | |
Cigna
| Facility | $11.89 | $11.89 | $85.00 | |
Cigna
| Professional | $11.89 | $11.89 | $54.56 | |
United
| Professional | $25.74 | $25.74 | $37.28 |