| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $224.20 | $2,747.00 | $8,017.00 | |
Capital Blue Cross
| Facility | $2,450.00 | $5,951.00 | $8,887.00 | |
Martin's Point
| Facility | $918.00 | $3,077.00 | $8,017.00 | |
UPMC Health Plan
| Facility | $176.92 | $201.05 | $328.16 | |
United
| Facility | $1,334.00 | $2,824.00 | $5,678.00 |