| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $131.03 | $131.03 | $132.81 | |
Aetna
| Professional | $120.16 | $131.03 | $164.87 | |
CareSource
| Facility | $125.05 | $143.81 | $187.58 | |
CareSource
| Professional | $127.00 | $190.50 | $294.45 | |
Cigna
| Facility | $214.92 | $214.92 | $214.92 | |
Cigna
| Professional | $120.27 | $165.14 | $505.57 | |
Highmark BCBS
| Professional | $168.80 | $184.50 | $277.88 | |
United
| Professional | $108.10 | $161.05 | $232.55 |