| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $641.00 | $2,667.00 | $12,901.00 | |
Capital Blue Cross
| Facility | $13,531.00 | $27,840.00 | $46,480.74 | |
Martin's Point
| Facility | $657.00 | $2,700.00 | $9,534.00 | |
UPMC Health Plan
| Facility | $32.63 | $32.63 | $38.86 | |
United
| Facility | $3,742.00 | $9,438.00 | $20,021.00 |