| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $141.63 | $141.63 | $259.10 | |
Aetna
| Professional | $129.55 | $141.63 | $146.82 | |
CareSource
| Facility | $190.00 | $259.10 | $302.27 | |
CareSource
| Professional | $207.28 | $207.28 | $233.19 | |
Cigna
| Facility | $140.34 | $336.24 | $518.13 | |
Cigna
| Professional | $258.97 | $279.98 | $832.56 | |
Highmark BCBS
| Facility | $300.23 | $326.95 | $799.70 | |
United
| Professional | $77.73 | $101.86 | $295.39 |