| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $79.06 | $126.31 | $1,400.00 | |
Aetna
| Professional | $78.79 | $122.06 | $200.86 | |
CareSource
| Facility | $83.96 | $100.75 | $109.78 | |
CareSource
| Professional | $97.58 | $97.58 | $97.58 | |
Cigna
| Facility | $147.53 | $147.53 | $147.53 | |
Cigna
| Professional | $81.31 | $136.07 | $348.52 | |
Highmark BCBS
| Professional | $173.39 | $189.51 | $194.59 | |
United
| Professional | $103.76 | $148.76 | $212.52 |