| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $13.78 | $13.78 | $13.78 | |
Aetna
| Professional | $13.33 | $15.31 | $16.88 | |
CareSource
| Facility | $15.00 | $33.72 | $43.72 | |
CareSource
| Professional | $16.23 | $29.98 | $57.92 | |
Cigna
| Facility | $29.27 | $29.27 | $29.27 | |
Cigna
| Professional | $10.19 | $10.19 | $120.40 | |
United
| Professional | $11.71 | $12.46 | $24.98 |