| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $198.71 | $247.12 | $627.96 |
Martin's Point
| Facility | 26 | $198.71 | $271.13 | $649.80 |
UPMC Health Plan
| Facility | 26 | $179.56 | $179.56 | $211.71 |
Ct Guidance &Monitoring Visc Tiss Ablation
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $198.71 | $247.12 | $627.96 |
Martin's Point
| Facility | 26 | $198.71 | $271.13 | $649.80 |
UPMC Health Plan
| Facility | 26 | $179.56 | $179.56 | $211.71 |