| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $164.60 | $164.60 | $164.60 | |
Aetna
| Professional | $164.59 | $164.60 | $181.06 | |
CareSource
| Facility | $44,999.55 | $44,999.55 | $44,999.55 | |
Cigna
| Facility | $158.97 | $175.41 | $175.41 | |
Cigna
| Professional | $175.41 | $175.41 | $228.75 | |
Highmark BCBS
| Facility | $243.63 | $243.63 | $243.63 | |
Highmark BCBS
| Professional | $216.03 | $216.03 | $216.03 | |
United
| Professional | $156.69 | $187.09 | $200.09 |