| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $81.28 | $100.00 | $125.89 | |
CareSource
| Facility | $213.80 | $213.80 | $213.80 | |
CareSource
| Professional | $190.55 | $190.55 | $190.55 | |
Cigna
| Professional | $57.54 | $57.54 | $660.69 | |
United
| Professional | $52.48 | $63.10 | $79.43 |