| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,864.65 | $2,864.65 | $2,864.65 | |
CareSource
| Facility | $112.82 | $126.74 | $138.09 | |
Cigna
| Facility | $120.00 | $120.00 | $120.00 | |
Cigna
| Facility | 52 | $94.25 | $94.25 | $94.25 |
Highmark BCBS
| Facility | $2,582.42 | $2,582.42 | $2,582.42 |