| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $262.89 | $262.89 | $1,600.00 | |
CareSource
| Facility | $295.22 | $327.96 | $357.32 | |
Cigna
| Facility | $315.97 | $315.97 | $315.97 | |
Highmark BCBS
| Facility | $5,783.66 | $5,783.66 | $5,783.66 |