| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $37.09 | $37.09 | $53.40 | |
Aetna
| Professional | $24.34 | $37.09 | $37.09 | |
BCBS
| Facility | $219,999.78 | $539,999.46 | $949,999.05 | |
BCBS
| Professional | $35.77 | $47.34 | $52.60 | |
CareSource
| Facility | $41.67 | $41.67 | $41.67 | |
CareSource
| Professional | $41.67 | $41.67 | $41.67 | |
Cigna
| Facility | $33.34 | $38.15 | $42.22 | |
Cigna
| Professional | $32.36 | $38.15 | $42.22 | |
Qualchoice
| Professional | $49.88 | $49.88 | $49.88 | |
United
| Facility | $55.06 | $55.06 | $64.78 | |
United
| Professional | $19.73 | $29.59 | $40.21 |