| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $484.69 | $750.26 | $1,400.00 | |
CareSource
| Facility | $528.00 | $581.03 | $633.03 | |
Cigna
| Facility | $846.64 | $846.64 | $846.64 | |
Highmark BCBS
| Facility | $19,981.55 | $19,981.55 | $19,981.55 |