| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $709.81 | $709.81 | $1,400.00 | |
CareSource
| Facility | $803.96 | $889.61 | $969.23 | |
Cigna
| Facility | $859.98 | $859.98 | $859.98 | |
Cigna
| Facility | AS | $84.48 | $84.48 | $84.48 |
Highmark BCBS
| Facility | $18,530.68 | $18,530.68 | $29,791.55 |