| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $23.52 | $23.52 | $23.52 | |
Aetna
| Professional | $20.73 | $26.13 | $28.81 | |
CareSource
| Facility | $25.64 | $57.56 | $74.62 | |
CareSource
| Professional | $27.72 | $51.17 | $98.87 | |
Cigna
| Facility | $49.97 | $49.97 | $49.97 | |
Cigna
| Professional | $17.39 | $17.39 | $205.52 | |
United
| Professional | $20.00 | $21.27 | $42.64 |