| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $832.00 | $4,534.00 | $8,240.00 | |
Capital Blue Cross
| Facility | $2,800.00 | $7,463.00 | $11,048.00 | |
Martin's Point
| Facility | $926.00 | $4,761.00 | $8,247.00 | |
UPMC Health Plan
| Facility | $449.77 | $449.77 | $549.54 | |
United
| Facility | $1,334.00 | $2,824.00 | $5,678.00 |