| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $1,613.85 | $1,613.85 | $1,933.58 | |
Priority Health
| Professional | $1,613.85 | $1,613.85 | $1,933.58 | |
UPMC Health Plan
| Facility | $1,720.16 | $1,720.16 | $2,016.93 | |
UPMC Health Plan
| Professional | $1,720.16 | $1,848.10 | $2,016.93 |