| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $37.15 | $56.23 | $95.50 | |
Aetna
| Professional | 26 | $18.20 | $21.88 | $53.70 |
Aetna
| Professional | TC | $15.85 | $33.88 | $60.26 |
Cigna
| Professional | $45.71 | $53.70 | $123.03 | |
Cigna
| Professional | 26 | $19.50 | $26.92 | $43.65 |
Cigna
| Professional | TC | $20.42 | $28.18 | $63.10 |
Highmark BCBS
| Professional | 26 | $302.00 | $302.00 | $302.00 |
United
| Professional | $35.48 | $51.29 | $107.15 | |
United
| Professional | 26 | $17.38 | $25.12 | $47.86 |
United
| Professional | TC | $15.85 | $25.12 | $58.88 |