| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $30.90 | $41.69 | $53.70 | |
CareSource
| Facility | $67.61 | $67.61 | $67.61 | |
CareSource
| Professional | $58.88 | $58.88 | $58.88 | |
Cigna
| Professional | $23.99 | $23.99 | $275.42 | |
United
| Professional | $23.99 | $30.20 | $38.02 |