| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $107.53 | $174.92 | $1,700.00 | |
CareSource
| Facility | $116.13 | $131.22 | $142.97 | |
Cigna
| Facility | $186.21 | $186.21 | $186.21 | |
Highmark BCBS
| Facility | $2,826.60 | $2,826.60 | $2,826.60 |