| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $42.28 | $49.80 | $62.80 | |
CareSource
| Facility | $65.52 | $86.06 | $96.82 | |
CareSource
| Professional | $68.70 | $78.89 | $166.28 | |
Cigna
| Facility | $70.56 | $70.56 | $70.56 | |
Cigna
| Professional | $25.82 | $25.82 | $25.82 | |
United
| Professional | $27.04 | $35.78 | $59.90 |