| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $245.00 | $432.00 | $432.00 | |
CareSource
| Facility | $22.83 | $91.31 | $213.05 | |
Highmark BCBS
| Professional | QX | $239.77 | $321.64 | $346.50 |
Highmark BCBS
| Professional | QY | $345.04 | $345.04 | $345.04 |