| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $234.96 | $358.94 | $1,600.00 | |
CareSource
| Facility | $249.46 | $277.98 | $302.86 | |
Cigna
| Facility | $267.37 | $267.37 | $267.37 | |
Highmark BCBS
| Facility | $658.42 | $658.42 | $658.42 |