| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $163.24 | $163.24 | $192.05 | |
Aetna
| Professional | $163.24 | $163.24 | $179.56 | |
CareSource
| Facility | $90.62 | $93.57 | $59,999.40 | |
CareSource
| Professional | $229.04 | $229.04 | $229.04 | |
Cigna
| Facility | $150.00 | $179.39 | $179.39 | |
Cigna
| Professional | $179.39 | $179.39 | $506.73 | |
Highmark BCBS
| Facility | $725.77 | $725.77 | $738.02 | |
United
| Professional | $164.98 | $192.05 | $210.66 |