| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,584.89 | $6,606.93 | $9,772.37 | |
Capital Blue Cross
| Facility | $20,417.38 | $21,379.62 | $57,543.99 | |
Martin's Point
| Facility | $1,122.02 | $5,370.32 | $9,772.37 | |
UPMC Health Plan
| Facility | $2,187.76 | $2,630.27 | $2,630.27 | |
United
| Facility | $660.69 | $2,570.40 | $6,760.83 |