| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $400.06 | $400.06 | $1,700.00 | |
CareSource
| Facility | $402.65 | $455.62 | $496.40 | |
Cigna
| Facility | $431.94 | $431.94 | $431.94 | |
Highmark BCBS
| Facility | $15,213.19 | $15,213.19 | $15,213.19 |