| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $90.35 | $90.35 | $1,400.00 | |
CareSource
| Facility | $99.71 | $110.66 | $120.57 | |
Cigna
| Facility | $106.61 | $106.61 | $106.61 | |
Highmark BCBS
| Facility | $1,718.77 | $1,718.77 | $1,718.77 |