| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $61.66 | $138.04 | $204.17 |
Cigna
| Facility | 26 | $12.88 | $60.26 | $85.11 |
Martin's Point
| Facility | 26 | $61.66 | $138.04 | $199.53 |
UPMC Health Plan
| Facility | 26 | $52.48 | $63.10 | $63.10 |