| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $768.00 | $3,839.00 | $8,113.00 | |
Capital Blue Cross
| Facility | $13,531.00 | $27,840.00 | $57,255.43 | |
Martin's Point
| Facility | $954.00 | $4,070.00 | $8,427.00 | |
UPMC Health Plan
| Facility | $311.02 | $311.02 | $459.46 | |
United
| Facility | $3,340.00 | $7,947.00 | $30,788.00 |