| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11.01 | $11.01 | $11.01 | |
Aetna
| Professional | $14.00 | $14.51 | $24.13 | |
CareSource
| Facility | $15.88 | $15.88 | $15.88 | |
CareSource
| Professional | $15.88 | $15.88 | $15.88 | |
Cigna
| Facility | $46.87 | $46.87 | $46.87 | |
Cigna
| Professional | $14.00 | $48.98 | $196.46 | |
Highmark BCBS
| Professional | $19.64 | $19.64 | $19.64 | |
United
| Professional | $29.30 | $47.21 | $70.04 |