| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $83.79 | $120.25 | $293.73 |
Cigna
| Facility | 26 | $106.76 | $106.76 | $106.76 |
Martin's Point
| Facility | 26 | $91.79 | $171.65 | $300.14 |
Priority Health
| Facility | 26 | $106.76 | $106.76 | $106.76 |
UPMC Health Plan
| Facility | 26 | $91.58 | $91.58 | $115.50 |