| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $95.74 | $105.88 | $141.16 | |
CareSource
| Facility | $148.35 | $193.46 | $232.20 | |
CareSource
| Professional | $161.22 | $201.53 | $373.79 | |
Cigna
| Facility | $201.56 | $201.56 | $201.56 | |
Cigna
| Professional | $61.92 | $61.92 | $61.92 | |
United
| Professional | $64.36 | $80.43 | $134.66 |