| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $44.67 | $87.10 | $147.91 |
Cigna
| Facility | 26 | $9.55 | $44.67 | $63.10 |
Martin's Point
| Facility | 26 | $44.67 | $75.86 | $138.04 |
UPMC Health Plan
| Facility | 26 | $28.84 | $28.84 | $38.90 |