| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $222.70 | $222.70 | $222.70 | |
Capital Blue Cross
| Facility | $967.00 | $967.00 | $967.00 | |
Highmark BCBS
| Facility | $4,700.00 | $7,402.50 | $12,613.03 | |
Martin's Point
| Facility | $222.70 | $222.70 | $222.70 | |
United
| Facility | $200.00 | $595.00 | $4,300.00 |