| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $204.62 | $204.62 | $204.62 | |
Aetna
| Professional | $30.00 | $30.00 | $50.00 | |
Cigna
| Professional | $84.00 | $130.00 | $222.00 | |
Highmark BCBS
| Professional | $103.52 | $103.52 | $103.52 |