| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.84 | $14.84 | $14.84 | |
Aetna
| Professional | $19.00 | $19.43 | $28.21 | |
CareSource
| Facility | $18.68 | $18.68 | $18.68 | |
CareSource
| Professional | $18.68 | $18.68 | $18.68 | |
Cigna
| Facility | $54.68 | $54.68 | $54.68 | |
Cigna
| Professional | $24.00 | $57.00 | $229.19 | |
Highmark BCBS
| Professional | $22.54 | $22.54 | $22.54 | |
United
| Professional | $34.47 | $47.87 | $81.97 |