| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $49.91 | $66.69 | $159.71 |
Cigna
| Facility | 26 | $59.32 | $59.32 | $59.32 |
Martin's Point
| Facility | 26 | $49.91 | $93.33 | $163.21 |
Priority Health
| Facility | 26 | $37.25 | $59.32 | $59.32 |
UPMC Health Plan
| Facility | 26 | $50.89 | $50.89 | $57.34 |