| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Highmark BCBS
| Facility | $6.05 | $6.05 | $22.61 |
Special Charges-Other Special Charges
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Highmark BCBS
| Facility | $6.05 | $6.05 | $22.61 |