| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Oscar Health
| Professional | $25.00 | $2,385.10 | $3,201.70 | |
UPMC Health Plan
| Facility | $1,255.42 | $1,255.42 | $2,157.54 | |
UPMC Health Plan
| Professional | $1,202.04 | $1,276.76 | $2,157.54 |