| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $116.36 | $860.99 | $1,600.00 | |
CareSource
| Facility | $124.41 | $138.30 | $150.69 | |
Cigna
| Facility | $199.49 | $199.49 | $199.49 | |
Highmark BCBS
| Facility | $945.16 | $945.16 | $945.16 |