| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,038.24 | $4,038.24 | $4,038.24 | |
CareSource
| Facility | $102.77 | $113.24 | $123.38 | |
Cigna
| Facility | $110.24 | $110.24 | $110.24 | |
Highmark BCBS
| Facility | $304.51 | $304.51 | $304.51 |