| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $127.55 | $189.50 | $189.88 | |
Aetna
| Professional | $127.54 | $127.55 | $140.30 | |
CareSource
| Facility | $53.81 | $55.57 | $80.72 | |
CareSource
| Professional | $124.77 | $124.77 | $124.77 | |
Cigna
| Facility | $121.82 | $134.47 | $134.47 | |
Cigna
| Professional | $134.47 | $134.47 | $173.58 | |
Highmark BCBS
| Facility | $121.53 | $121.53 | $343.70 | |
Highmark BCBS
| Professional | $165.54 | $165.54 | $165.54 | |
United
| Professional | $120.06 | $134.99 | $192.10 |