| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $51.65 | $68.76 | $165.28 |
Cigna
| Facility | 26 | $60.00 | $60.00 | $60.00 |
Martin's Point
| Facility | 26 | $51.65 | $96.37 | $168.90 |
Priority Health
| Facility | 26 | $37.50 | $60.00 | $60.00 |
UPMC Health Plan
| Facility | 26 | $52.15 | $52.15 | $57.34 |