| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $79.36 | $133.22 | $1,400.00 | |
Aetna
| Professional | $79.36 | $127.35 | $224.03 | |
CareSource
| Facility | $83.22 | $101.10 | $122.39 | |
CareSource
| Professional | $97.91 | $259.70 | $305.54 | |
Cigna
| Facility | $148.05 | $148.05 | $148.05 | |
Cigna
| Professional | $81.59 | $143.00 | $354.98 | |
Highmark BCBS
| Professional | $191.27 | $191.27 | $202.22 | |
United
| Professional | $108.46 | $143.26 | $231.09 |