| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $724.48 | $724.48 | $1,600.00 | |
CareSource
| Facility | $745.22 | $809.69 | $882.16 | |
Cigna
| Facility | $813.12 | $813.12 | $813.12 | |
Highmark BCBS
| Facility | $4,723.64 | $4,723.64 | $4,723.64 |