| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $524.14 | $980.00 | $1,820.00 |
Aetna
| Professional | QZ | $630.23 | $630.23 | $630.23 |
Highmark BCBS
| Professional | AA | $548.73 | $663.07 | $1,100.48 |
Highmark BCBS
| Professional | QZ | $450.90 | $595.41 | $818.69 |
Martin's Point
| Professional | AA | $524.14 | $1,134.00 | $1,960.00 |
Martin's Point
| Professional | QZ | $630.23 | $630.23 | $630.23 |