| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $616.60 | $660.69 | $6,025.60 | |
Aetna
| Facility | 50 | $6,309.57 | $12,589.25 | $14,454.40 |
Highmark BCBS
| Facility | $12,589.25 | $12,589.25 | $30,902.95 | |
Highmark BCBS
| Facility | 50 | $4,786.30 | $4,786.30 | $4,786.30 |