| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | AA | $815.37 | $815.37 | $815.37 |
Highmark BCBS
| Professional | AA | $430.00 | $1,470.26 | $2,131.38 |
Highmark BCBS
| Professional | QX | $420.00 | $564.19 | $823.59 |
Highmark BCBS
| Professional | QY | $575.00 | $892.50 | $1,529.47 |
Highmark BCBS
| Professional | QZ | $693.75 | $888.75 | $1,200.00 |