| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $468.92 | $584.15 | $1,600.00 | |
CareSource
| Facility | $512.20 | $566.79 | $617.53 | |
Cigna
| Facility | $821.30 | $821.30 | $821.30 | |
Highmark BCBS
| Facility | $15,794.47 | $15,794.47 | $15,794.47 |