| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $109.03 | $109.03 | $109.03 | |
Aetna
| Professional | $75.05 | $109.03 | $109.03 | |
BCBS
| Facility | $219,999.78 | $539,999.46 | $949,999.05 | |
BCBS
| Professional | $105.13 | $139.15 | $154.61 | |
CareSource
| Facility | $122.50 | $122.50 | $122.50 | |
CareSource
| Professional | $122.50 | $122.50 | $122.50 | |
Cigna
| Facility | $98.00 | $128.79 | $128.79 | |
Cigna
| Professional | $94.02 | $95.14 | $128.79 | |
United
| Professional | $57.99 | $92.11 | $127.46 |