| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $64.57 | $117.49 | $117.49 | |
Aetna
| Professional | $54.95 | $63.10 | $74.13 | |
CareSource
| Facility | $107.15 | $107.15 | $107.15 | |
CareSource
| Professional | $95.50 | $95.50 | $95.50 | |
Cigna
| Facility | $66.07 | $125.89 | $234.42 | |
Cigna
| Professional | $380.19 | $380.19 | $380.19 | |
United
| Professional | $33.11 | $35.48 | $97.72 |