| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $417.00 | $563.00 | $670.00 | |
Fidelis
| Facility | $163.62 | $539.48 | $1,477.19 | |
Highmark BCBS
| Facility | $164.55 | $402.58 | $684.00 |
Other Diagnostic Services-General Classification
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Anthem BCBS
| Facility | $417.00 | $563.00 | $670.00 | |
Fidelis
| Facility | $163.62 | $539.48 | $1,477.19 | |
Highmark BCBS
| Facility | $164.55 | $402.58 | $684.00 |