| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.25 | $43.37 | $1,400.00 | |
Aetna
| Professional | $11.59 | $25.25 | $44.09 | |
CareSource
| Facility | $23.53 | $29.41 | $35.72 | |
CareSource
| Professional | $27.68 | $79.54 | $93.58 | |
Cigna
| Facility | $39.32 | $39.32 | $39.32 | |
Cigna
| Professional | $18.39 | $33.33 | $87.67 | |
Highmark BCBS
| Facility | $5,018.10 | $5,018.10 | $5,018.10 | |
United
| Professional | $37.35 | $54.79 | $106.43 |