| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $921.00 | $4,761.00 | $8,933.00 | |
Capital Blue Cross
| Facility | $13,531.00 | $27,840.00 | $46,480.74 | |
Martin's Point
| Facility | $1,054.00 | $5,350.00 | $10,247.00 | |
UPMC Health Plan
| Facility | $455.66 | $455.66 | $498.39 | |
United
| Facility | $2,222.00 | $3,475.00 | $6,000.00 |