| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.50 | $28.50 | $28.50 | |
Aetna
| Professional | $20.49 | $28.50 | $28.50 | |
BCBS
| Facility | $219,999.78 | $539,999.46 | $949,999.05 | |
BCBS
| Professional | $44.28 | $58.61 | $65.12 | |
CareSource
| Facility | $49.46 | $49.46 | $64.06 | |
CareSource
| Professional | $64.06 | $64.06 | $64.06 | |
Cigna
| Facility | $30.91 | $30.91 | $41.03 | |
Cigna
| Professional | $22.56 | $30.91 | $40.07 | |
United
| Professional | $16.45 | $23.86 | $33.26 |