| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $113.01 | $113.01 | $113.01 | |
Aetna
| Professional | $84.25 | $113.01 | $113.01 | |
Ambetter
| Professional | $162.66 | $162.66 | $162.66 | |
BCBS
| Facility | $219,999.78 | $539,999.46 | $949,999.05 | |
BCBS
| Professional | $175.53 | $232.32 | $258.13 | |
CareSource
| Facility | $197.31 | $197.31 | $203.34 | |
CareSource
| Professional | $197.31 | $197.31 | $197.31 | |
Cigna
| Facility | $112.67 | $112.67 | $162.66 | |
Cigna
| Professional | $82.25 | $112.67 | $158.85 | |
Qualchoice
| Professional | $187.06 | $187.06 | $187.06 | |
United
| Professional | $59.97 | $91.58 | $122.23 |