| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $418.56 | $2,070.00 | $7,629.00 | |
Capital Blue Cross
| Facility | $4,092.00 | $7,463.00 | $11,048.00 | |
Martin's Point
| Facility | $594.00 | $2,266.00 | $8,017.00 | |
UPMC Health Plan
| Facility | $305.51 | $376.65 | $1,045.08 | |
United
| Facility | $1,334.00 | $2,824.00 | $5,678.00 |