| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.19 | $21.99 | $24.19 | |
Aetna
| Professional | $19.00 | $19.00 | $21.10 | |
CareSource
| Facility | $19.00 | $19.00 | $28.50 | |
CareSource
| Professional | $19.00 | $19.00 | $44.05 | |
Cigna
| Facility | $13.34 | $90.07 | $90.07 | |
Cigna
| Professional | $19.00 | $19.00 | $19.00 | |
United
| Professional | $19.00 | $20.90 | $105.98 |