| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $72.00 | $72.00 | $72.00 | |
Aetna
| Professional | $72.00 | $72.00 | $78.03 | |
BCBS
| Facility | $219,999.78 | $539,999.46 | $949,999.05 | |
BCBS
| Professional | $114.60 | $151.68 | $168.53 | |
CareSource
| Facility | $133.52 | $133.52 | $133.52 | |
CareSource
| Professional | $133.52 | $133.52 | $133.52 | |
Cigna
| Facility | $52.17 | $52.17 | $106.82 | |
Cigna
| Professional | $38.08 | $52.17 | $103.71 | |
United
| Professional | $63.35 | $102.95 | $141.34 |