| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $116.56 | $116.56 | $492.56 | |
Aetna
| Professional | $47.46 | $53.37 | $62.15 | |
CareSource
| Facility | $67.15 | $129.47 | $180.78 | |
CareSource
| Professional | $67.13 | $72.31 | $115.08 | |
Cigna
| Facility | $59.92 | $59.92 | $116.62 | |
Cigna
| Professional | $43.74 | $67.98 | $79.80 | |
Highmark BCBS
| Facility | $270.00 | $270.00 | $270.00 | |
United
| Professional | $19.47 | $51.53 | $77.63 |