| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,557.09 | $1,557.09 | $1,557.09 | |
Aetna
| Professional | $1,557.09 | $1,557.09 | $3,202.53 | |
Highmark BCBS
| Professional | $2,900.00 | $2,900.00 | $2,900.00 | |
Martin's Point
| Facility | $1,557.09 | $1,557.09 | $1,557.09 | |
Martin's Point
| Professional | $1,557.09 | $1,557.09 | $3,202.53 |