| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $140.63 | $233.10 | $668.71 | |
Aetna
| Professional | $260.20 | $260.20 | $260.20 | |
Cigna
| Professional | $260.20 | $260.20 | $260.20 | |
Highmark BCBS
| Facility | $147.72 | $147.72 | $242.48 | |
United
| Professional | $244.90 | $260.20 | $382.65 |