| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $195.35 | $3,839.00 | $8,247.00 | |
Capital Blue Cross
| Facility | $13,531.00 | $27,840.00 | $46,480.74 | |
Martin's Point
| Facility | $657.00 | $4,761.00 | $8,247.00 | |
UPMC Health Plan
| Facility | $175.40 | $175.40 | $192.73 | |
United
| Facility | $625.00 | $2,391.00 | $6,228.00 |