| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $113.09 | $113.09 | $113.09 | |
Aetna
| Professional | $20.00 | $20.00 | $20.00 | |
CareSource
| Facility | $19.42 | $26.48 | $63.59 | |
CareSource
| Professional | $9.36 | $9.36 | $9.36 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $6.59 | $28.91 | $28.91 | |
Highmark BCBS
| Facility | $131.19 | $131.19 | $139.47 |