| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.17 | $21.17 | $30.00 | |
Highmark BCBS
| Professional | AA | $362.15 | $362.15 | $390.00 |
Highmark BCBS
| Professional | QK | $315.00 | $354.56 | $476.25 |
Highmark BCBS
| Professional | QX | $288.38 | $341.62 | $470.63 |
Highmark BCBS
| Professional | QY | $277.50 | $303.33 | $473.08 |
Highmark BCBS
| Professional | QZ | $377.85 | $545.00 | $682.50 |