| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $77.62 | $91.20 | $134.90 | |
Cigna
| Facility | $91.20 | $91.20 | $91.20 | |
Cigna
| Professional | $77.62 | $77.62 | $91.20 | |
Highmark BCBS
| Professional | $112.20 | $112.20 | $112.20 | |
United
| Facility | $6.76 | $63.10 | $112.20 | |
United
| Professional | $69.18 | $87.10 | $128.82 |