| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $325.70 | $325.70 | $325.70 | |
Aetna
| Professional | $242.81 | $325.70 | $325.70 | |
Ambetter
| Professional | $468.80 | $468.80 | $468.80 | |
BCBS
| Facility | $219,999.78 | $539,999.46 | $949,999.05 | |
BCBS
| Professional | $505.89 | $669.56 | $743.95 | |
CareSource
| Facility | $568.90 | $568.90 | $586.05 | |
CareSource
| Professional | $568.90 | $568.90 | $568.90 | |
Cigna
| Facility | $325.37 | $325.37 | $468.80 | |
Cigna
| Professional | $237.52 | $325.37 | $457.82 | |
United
| Professional | $173.18 | $272.45 | $352.30 |