| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $214.65 | $224.21 | $224.21 | |
Capital Blue Cross
| Facility | $950.35 | $1,366.00 | $8,459.92 | |
Martin's Point
| Facility | $224.21 | $224.21 | $224.21 | |
UPMC Health Plan
| Facility | $204.15 | $204.15 | $207.71 | |
United
| Facility | $625.00 | $2,391.00 | $6,322.00 |