| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,445.44 | $5,370.32 | $8,511.38 | |
Capital Blue Cross
| Facility | $5,011.87 | $6,165.95 | $57,543.99 | |
Martin's Point
| Facility | $1,023.29 | $4,570.88 | $8,511.38 | |
UPMC Health Plan
| Facility | $588.84 | $588.84 | $1,584.89 | |
United
| Facility | $1,348.96 | $3,311.31 | $6,606.93 |