| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $86.82 | $134.63 | $1,400.00 | |
Aetna
| Professional | $86.82 | $134.63 | $166.08 | |
CareSource
| Facility | $92.90 | $111.48 | $121.46 | |
CareSource
| Professional | $107.96 | $107.96 | $107.96 | |
Cigna
| Facility | $162.78 | $162.78 | $162.78 | |
Cigna
| Professional | $90.02 | $145.26 | $374.38 | |
Highmark BCBS
| Professional | $197.80 | $197.80 | $197.80 | |
United
| Professional | $111.54 | $157.94 | $225.63 |