| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | QX | $489.78 | $489.78 | $489.78 |
Aetna
| Professional | AA | $436.52 | $645.65 | $724.44 |
Highmark BCBS
| Professional | AA | $467.74 | $501.19 | $3,311.31 |
Highmark BCBS
| Professional | QZ | $602.56 | $724.44 | $794.33 |