| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $64.70 | $64.70 | $64.70 | |
Aetna
| Professional | $48.26 | $64.70 | $64.70 | |
BCBS
| Facility | $219,999.78 | $539,999.46 | $949,999.05 | |
BCBS
| Professional | $100.50 | $133.02 | $147.80 | |
CareSource
| Facility | $113.11 | $113.11 | $116.46 | |
CareSource
| Professional | $113.11 | $113.11 | $113.11 | |
Cigna
| Facility | $64.66 | $64.66 | $93.14 | |
Cigna
| Professional | $47.20 | $64.66 | $90.95 | |
United
| Professional | $34.42 | $52.44 | $70.15 |