| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $83.90 | $83.90 | $83.90 | |
Aetna
| Professional | $67.48 | $83.90 | $90.65 | |
BCBS
| Facility | $219,999.78 | $539,999.46 | $949,999.05 | |
BCBS
| Professional | $130.30 | $172.46 | $191.62 | |
CareSource
| Facility | $162.87 | $162.87 | $181.44 | |
CareSource
| Professional | $181.44 | $181.44 | $181.44 | |
Cigna
| Facility | $117.36 | $117.36 | $126.78 | |
Cigna
| Professional | $85.67 | $117.36 | $117.92 | |
United
| Professional | $50.20 | $71.95 | $100.86 |