| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $27.99 | $27.99 | $30.63 | |
Aetna
| Professional | $30.32 | $30.32 | $33.69 | |
CareSource
| Facility | $30.32 | $45.48 | $45.48 | |
Cigna
| Facility | $23.58 | $30.32 | $333.67 | |
Cigna
| Professional | $30.32 | $30.32 | $498.54 | |
United
| Professional | $30.32 | $33.75 | $392.55 |