| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $69.18 | $158.49 | $229.09 |
Cigna
| Facility | 26 | $14.45 | $67.61 | $97.72 |
Martin's Point
| Facility | 26 | $69.18 | $158.49 | $218.78 |
UPMC Health Plan
| Facility | 26 | $58.88 | $58.88 | $66.07 |