| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $69.48 | $141.49 | $1,400.00 | |
Aetna
| Professional | $63.71 | $107.46 | $164.47 | |
CareSource
| Facility | $72.56 | $87.07 | $94.86 | |
CareSource
| Professional | $84.32 | $84.32 | $84.32 | |
Cigna
| Facility | $126.24 | $126.24 | $126.24 | |
Cigna
| Professional | $70.83 | $148.52 | $347.67 | |
Highmark BCBS
| Professional | $170.00 | $190.53 | $208.24 | |
United
| Professional | $107.25 | $146.21 | $195.58 |