| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $18.57 | $18.57 | $18.57 | |
Aetna
| Professional | $17.98 | $20.64 | $22.76 | |
CareSource
| Facility | $20.23 | $45.47 | $58.94 | |
CareSource
| Professional | $21.89 | $40.42 | $78.08 | |
Cigna
| Facility | $39.47 | $39.47 | $39.47 | |
Cigna
| Professional | $13.74 | $13.74 | $162.34 | |
United
| Professional | $16.20 | $16.80 | $33.68 |