| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $50.12 | $131.83 | $204.17 |
Cigna
| Facility | 26 | $12.59 | $58.88 | $83.18 |
Martin's Point
| Facility | 26 | $50.12 | $109.65 | $204.17 |
UPMC Health Plan
| Facility | 26 | $51.29 | $61.66 | $61.66 |