| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $117.05 | $139.71 | $908.98 | |
Aetna
| Professional | $90.75 | $116.41 | $137.94 | |
CareSource
| Facility | $97.80 | $115.58 | $207.45 | |
CareSource
| Professional | $137.76 | $137.76 | $140.21 | |
Cigna
| Facility | $197.86 | $197.86 | $197.86 | |
Cigna
| Professional | $97.58 | $131.58 | $564.37 | |
Highmark BCBS
| Professional | $161.59 | $161.59 | $221.06 | |
United
| Professional | $98.49 | $144.11 | $229.50 |