| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $96.32 | $96.32 | $96.32 | |
Aetna
| Professional | $89.79 | $96.32 | $114.55 | |
CareSource
| Facility | $186.43 | $223.72 | $286.56 | |
CareSource
| Professional | $130.50 | $230.46 | $432.25 | |
Cigna
| Facility | $118.47 | $120.81 | $225.06 | |
Cigna
| Professional | $88.19 | $120.81 | $916.14 | |
Highmark BCBS
| Professional | $118.50 | $125.90 | $130.50 | |
United
| Professional | $80.14 | $100.18 | $155.02 |