| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
UPMC Health Plan
| Facility | $2,030.00 | $2,030.00 | $2,233.00 | |
UPMC Health Plan
| Professional | $2,030.00 | $2,030.00 | $2,233.00 |
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
UPMC Health Plan
| Facility | $2,030.00 | $2,030.00 | $2,233.00 | |
UPMC Health Plan
| Professional | $2,030.00 | $2,030.00 | $2,233.00 |