| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $13.41 | $13.41 | $13.41 | |
Aetna
| Professional | $13.41 | $17.01 | $50.73 | |
CareSource
| Facility | $24.31 | $30.39 | $40.11 | |
CareSource
| Professional | $24.31 | $56.36 | $56.36 | |
Cigna
| Facility | $28.49 | $28.49 | $28.49 | |
Cigna
| Professional | $9.92 | $9.92 | $117.17 | |
United
| Professional | $11.55 | $12.13 | $24.31 |