| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $67.58 | $70.44 | $99.80 | |
CareSource
| Facility | $104.71 | $136.76 | $153.86 | |
CareSource
| Professional | $113.97 | $129.02 | $264.24 | |
Cigna
| Facility | $126.00 | $126.00 | $126.00 | |
Cigna
| Professional | $41.03 | $41.03 | $41.03 | |
United
| Professional | $42.65 | $56.86 | $95.19 |