| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $138.91 | $138.91 | $138.91 | |
Aetna
| Professional | $138.91 | $138.91 | $138.91 | |
Capital Blue Cross
| Facility | $967.00 | $967.00 | $967.00 | |
Highmark BCBS
| Facility | $160.02 | $271.70 | $495.94 | |
Martin's Point
| Facility | $138.91 | $138.91 | $234.78 | |
Martin's Point
| Professional | $138.91 | $138.91 | $165.32 |