| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $140.44 | $140.44 | $1,400.00 | |
CareSource
| Facility | $159.24 | $175.98 | $191.73 | |
Cigna
| Facility | $167.52 | $167.52 | $167.52 | |
Highmark BCBS
| Facility | $8,167.88 | $8,167.88 | $8,167.88 |