| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $54.62 | $65.78 | $174.78 |
Cigna
| Facility | 26 | $63.29 | $63.29 | $63.29 |
Martin's Point
| Facility | 26 | $54.62 | $72.65 | $178.61 |
Priority Health
| Facility | 26 | $22.69 | $63.29 | $63.29 |
UPMC Health Plan
| Facility | 26 | $36.47 | $55.09 | $55.09 |