| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $768.00 | $3,748.00 | $8,017.00 | |
Capital Blue Cross
| Facility | $5,000.00 | $57,255.43 | $109,917.12 | |
Martin's Point
| Facility | $954.00 | $3,964.00 | $8,017.00 | |
UPMC Health Plan
| Facility | $328.59 | $347.90 | $347.90 | |
United
| Facility | $3,340.00 | $7,935.00 | $19,143.00 |