| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Emblem Health
| Professional | $465.95 | $465.95 | $465.95 | |
UPMC Health Plan
| Facility | $354.49 | $354.49 | $390.32 | |
UPMC Health Plan
| Professional | $354.49 | $373.56 | $390.32 | |
United
| Professional | $328.17 | $449.87 | $701.34 |