| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.83 | $183.43 | $1,600.00 | |
CareSource
| Facility | $132.13 | $158.57 | $172.77 | |
Cigna
| Facility | $225.01 | $225.01 | $225.01 | |
Highmark BCBS
| Facility | $444.42 | $444.42 | $444.42 |