| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $125.00 | $151.34 | $400.00 |
Cigna
| Facility | 26 | $117.01 | $117.01 | $117.01 |
Martin's Point
| Facility | 26 | $125.00 | $178.75 | $408.75 |
Priority Health
| Facility | 26 | $117.01 | $117.01 | $117.01 |
UPMC Health Plan
| Facility | 26 | $100.23 | $100.23 | $119.19 |