| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $162.18 | $190.55 | $190.55 | |
Aetna
| Professional | $162.18 | $162.18 | $190.55 | |
CareSource
| Professional | $229.09 | $229.09 | $229.09 | |
Cigna
| Facility | $169.82 | $169.82 | $169.82 | |
Cigna
| Professional | $501.19 | $501.19 | $501.19 | |
Highmark BCBS
| Facility | $741.31 | $741.31 | $741.31 | |
United
| Professional | $165.96 | $190.55 | $208.93 |