| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $594.00 | $2,422.00 | $7,799.00 | |
Capital Blue Cross
| Facility | $5,000.00 | $8,639.91 | $79,506.39 | |
Martin's Point
| Facility | $641.00 | $2,422.00 | $8,017.00 | |
UPMC Health Plan
| Facility | $129.10 | $129.10 | $144.24 | |
United
| Facility | $144.00 | $650.00 | $3,742.00 |