| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $113.18 | $175.97 | $1,400.00 | |
Aetna
| Professional | $111.95 | $166.98 | $303.33 | |
CareSource
| Facility | $128.76 | $141.06 | $153.68 | |
CareSource
| Professional | $136.61 | $136.61 | $136.61 | |
Cigna
| Facility | $206.47 | $206.47 | $206.47 | |
Cigna
| Professional | $114.95 | $187.35 | $477.72 | |
Highmark BCBS
| Professional | $248.48 | $259.51 | $266.18 | |
United
| Professional | $144.47 | $213.88 | $301.32 |