| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Highmark BCBS
| Facility | $56.23 | $102.33 | $3,801.89 |
All Inclusive Ancillary-General Classification
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Highmark BCBS
| Facility | $56.23 | $102.33 | $3,801.89 |