| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $33.88 | $46.77 | $61.66 | |
CareSource
| Facility | $77.62 | $77.62 | $77.62 | |
CareSource
| Professional | $69.18 | $69.18 | $69.18 | |
Cigna
| Professional | $25.70 | $25.70 | $295.12 | |
United
| Professional | $25.70 | $34.67 | $45.71 |