| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $26.03 | $26.03 | $26.03 | |
Aetna
| Professional | $26.03 | $28.98 | $31.88 | |
CareSource
| Facility | $28.37 | $63.69 | $82.57 | |
CareSource
| Professional | $30.67 | $56.62 | $109.39 | |
Cigna
| Facility | $55.28 | $55.28 | $55.28 | |
Cigna
| Professional | $19.25 | $19.25 | $227.41 | |
United
| Professional | $22.72 | $23.54 | $47.18 |