| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $365.57 | $614.78 | $1,600.00 | |
CareSource
| Facility | $424.45 | $518.72 | $714.17 | |
Cigna
| Facility | $453.25 | $453.25 | $453.25 | |
Highmark BCBS
| Facility | $15,749.62 | $15,749.62 | $15,749.62 |