| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $243.95 | $410.38 | $1,400.00 | |
CareSource
| Facility | $256.49 | $307.79 | $384.74 | |
Cigna
| Facility | $293.27 | $293.27 | $293.27 | |
Cigna
| Facility | 62 | $179.89 | $179.89 | $179.89 |
Cigna
| Facility | AS | $28.78 | $28.78 | $28.78 |
Highmark BCBS
| Facility | $8,211.08 | $8,211.08 | $13,000.78 |