| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $13.03 | $13.03 | $13.03 | |
Aetna
| Professional | $13.03 | $14.56 | $15.96 | |
CareSource
| Facility | $14.19 | $31.87 | $41.32 | |
CareSource
| Professional | $15.35 | $28.33 | $54.74 | |
Cigna
| Facility | $27.67 | $27.67 | $27.67 | |
Cigna
| Professional | $9.63 | $9.63 | $113.80 | |
United
| Professional | $11.08 | $11.78 | $23.61 |