| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $38.29 | $38.61 | $57.63 | |
Aetna
| Professional | $38.29 | $62.16 | $86.58 | |
Aetna
| Professional | 25 | $66.01 | $79.45 | $154.76 |
Cigna
| Facility | $110.00 | $130.00 | $175.00 | |
Cigna
| Professional | $42.52 | $70.58 | $111.51 | |
Highmark BCBS
| Professional | $72.25 | $105.55 | $187.71 | |
Highmark BCBS
| Professional | 25 | $61.94 | $74.23 | $214.88 |
United
| Professional | $56.53 | $72.90 | $152.80 |