| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $26.92 | $77.62 | $77.62 | |
Aetna
| Professional | $25.70 | $25.70 | $32.36 | |
CareSource
| Facility | $26.92 | $26.92 | $26.92 | |
CareSource
| Professional | $26.92 | $26.92 | $26.92 | |
Cigna
| Facility | $25.70 | $85.11 | $85.11 | |
Cigna
| Professional | $26.92 | $26.92 | $114.82 | |
United
| Professional | $67.61 | $120.23 | $125.89 |