| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $94.94 | $470.10 | $1,400.00 | |
CareSource
| Facility | $100.76 | $111.35 | $121.31 | |
Cigna
| Facility | $161.57 | $161.57 | $161.57 | |
Highmark BCBS
| Facility | $4,564.07 | $4,564.07 | $4,564.07 |