| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $912.01 | $6,165.95 | $8,709.64 | |
Capital Blue Cross
| Facility | $20,417.38 | $21,379.62 | $57,543.99 | |
Martin's Point
| Facility | $912.01 | $4,786.30 | $8,511.38 | |
UPMC Health Plan
| Facility | $575.44 | $794.33 | $1,995.26 | |
United
| Facility | $660.69 | $2,570.40 | $6,760.83 |