| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $496.44 | $496.44 | $1,700.00 | |
CareSource
| Facility | $564.20 | $625.42 | $681.41 | |
Cigna
| Facility | $608.94 | $608.94 | $608.94 | |
Highmark BCBS
| Facility | $16,098.25 | $16,098.25 | $16,098.25 |