| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $832.00 | $3,839.00 | $8,017.00 | |
Capital Blue Cross
| Facility | $13,531.00 | $27,840.00 | $57,255.43 | |
Martin's Point
| Facility | $954.00 | $4,068.00 | $8,017.00 | |
UPMC Health Plan
| Facility | $313.49 | $328.28 | $328.28 | |
United
| Facility | $3,340.00 | $7,935.00 | $19,143.00 |