| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $540.00 | $5,526.00 | $13,947.00 | |
Capital Blue Cross
| Facility | $13,531.00 | $27,840.00 | $46,480.74 | |
Martin's Point
| Facility | $1,013.00 | $5,526.00 | $13,969.00 | |
UPMC Health Plan
| Facility | $223.17 | $223.17 | $267.19 | |
United
| Facility | $656.00 | $2,391.00 | $6,322.00 |