| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $64.95 | $71.45 | $205.27 |
Cigna
| Facility | 26 | $74.26 | $74.26 | $74.26 |
Martin's Point
| Facility | 26 | $64.95 | $118.88 | $212.42 |
Priority Health
| Facility | 26 | $43.22 | $74.26 | $74.26 |
UPMC Health Plan
| Facility | 26 | $64.92 | $64.92 | $71.50 |