| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.17 | $30.00 | $3,457.62 | |
Highmark BCBS
| Professional | AA | $484.81 | $765.00 | $937.50 |
Highmark BCBS
| Professional | QK | $550.00 | $2,486.61 | $3,216.81 |
Highmark BCBS
| Professional | QX | $434.79 | $540.29 | $3,060.05 |
Highmark BCBS
| Professional | QZ | $742.50 | $892.50 | $1,372.50 |