| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.73 | $53.27 | $53.27 | |
Aetna
| Facility | CO | $109.92 | $246.65 | $467.58 |
Aetna
| Facility | CQ | $28.69 | $44.17 | $199.04 |
Aetna
| Professional | $14.40 | $21.65 | $31.13 | |
Cigna
| Facility | $65.00 | $65.00 | $65.00 | |
Cigna
| Professional | $34.17 | $84.63 | $116.06 | |
Highmark BCBS
| Facility | CO | $91.82 | $91.82 | $91.82 |
United
| Professional | $24.89 | $33.35 | $78.09 |