| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.85 | $14.85 | $14.85 | |
Aetna
| Professional | $19.00 | $19.47 | $24.37 | |
CareSource
| Facility | $22.41 | $22.41 | $22.41 | |
CareSource
| Professional | $22.41 | $22.41 | $22.41 | |
Cigna
| Facility | $37.28 | $37.28 | $37.28 | |
Cigna
| Professional | $23.00 | $38.90 | $155.93 | |
Highmark BCBS
| Professional | $19.68 | $19.68 | $19.68 | |
United
| Professional | $23.29 | $39.40 | $56.74 |