| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $242.87 | $408.30 | $1,400.00 | |
CareSource
| Facility | $288.58 | $316.20 | $344.51 | |
Cigna
| Facility | $306.89 | $306.89 | $306.89 | |
Highmark BCBS
| Facility | $1,159.64 | $1,159.64 | $1,159.64 |