| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $831.76 | $6,606.93 | $14,454.40 | |
Capital Blue Cross
| Facility | $6,456.54 | $7,585.78 | $57,543.99 | |
Martin's Point
| Facility | $724.44 | $5,370.32 | $11,220.18 | |
UPMC Health Plan
| Facility | $549.54 | $691.83 | $691.83 | |
United
| Facility | $2,089.30 | $3,981.07 | $9,772.37 |