| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.17 | $21.17 | $30.00 | |
Highmark BCBS
| Professional | AA | $249.03 | $321.26 | $385.51 |
Highmark BCBS
| Professional | QK | $215.00 | $255.00 | $408.75 |
Highmark BCBS
| Professional | QX | $236.03 | $292.70 | $366.09 |
Highmark BCBS
| Professional | QY | $250.00 | $338.00 | $440.00 |
Highmark BCBS
| Professional | QZ | $221.19 | $427.50 | $545.00 |