| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $806.00 | $2,371.00 | $7,799.00 | |
Capital Blue Cross
| Facility | $6,431.95 | $7,827.00 | $19,139.18 | |
Martin's Point
| Facility | $657.00 | $2,371.00 | $8,017.00 | |
UPMC Health Plan
| Facility | $762.99 | $762.99 | $823.33 | |
United
| Facility | $2,332.00 | $5,762.00 | $16,362.19 |