| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $88.45 | $2,463.00 | $7,799.00 | |
Capital Blue Cross
| Facility | $3,736.00 | $4,444.00 | $15,949.31 | |
Martin's Point
| Facility | $117.50 | $2,467.00 | $8,017.00 | |
UPMC Health Plan
| Facility | $60.75 | $72.55 | $99.20 | |
United
| Facility | $162.00 | $553.00 | $3,742.00 |