| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $107.15 | $758.58 | $1,621.81 | |
Aetna
| Professional | $75.86 | $75.86 | $380.19 | |
Cigna
| Facility | $107.15 | $275.42 | $912.01 | |
Highmark BCBS
| Facility | $104.71 | $724.44 | $1,380.38 |