| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.57 | $17.57 | $17.57 | |
Aetna
| Professional | $17.57 | $19.69 | $21.53 | |
CareSource
| Facility | $22.58 | $31.86 | $55.76 | |
CareSource
| Professional | $22.58 | $22.58 | $73.87 | |
Cigna
| Facility | $37.33 | $37.33 | $37.33 | |
Cigna
| Professional | $16.27 | $16.27 | $154.38 | |
Highmark BCBS
| Facility | $1,980.63 | $1,980.63 | $1,980.63 | |
United
| Professional | $14.81 | $15.95 | $31.86 |