| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $307.22 | $307.22 | $1,700.00 | |
CareSource
| Facility | $324.04 | $370.39 | $403.56 | |
Cigna
| Facility | $347.36 | $347.36 | $347.36 | |
Highmark BCBS
| Facility | $29,368.20 | $29,368.20 | $29,368.20 |