| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $104.71 | $190.55 | $190.55 | |
Aetna
| Professional | $89.13 | $109.65 | $162.18 | |
CareSource
| Facility | $173.78 | $173.78 | $177.83 | |
CareSource
| Professional | $128.82 | $154.88 | $213.80 | |
Cigna
| Facility | $107.15 | $275.42 | $389.05 | |
Cigna
| Professional | $69.18 | $616.60 | $616.60 | |
Highmark BCBS
| Facility | $891.25 | $891.25 | $891.25 | |
United
| Facility | $77.62 | $77.62 | $77.62 | |
United
| Professional | $57.54 | $74.13 | $173.78 |