| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $182.59 | $282.77 | $1,600.00 | |
CareSource
| Facility | $196.61 | $218.98 | $238.59 | |
Cigna
| Facility | $209.81 | $209.81 | $209.81 | |
Highmark BCBS
| Facility | $13,529.04 | $13,529.04 | $13,529.04 |