| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $27.36 | $27.36 | $27.36 | |
Aetna
| Professional | $69.73 | $69.73 | $192.03 | |
Cigna
| Professional | $69.73 | $69.73 | $95.63 | |
Highmark BCBS
| Facility | $156.30 | $156.30 | $156.30 | |
United
| Professional | $27.89 | $69.73 | $161.13 |