| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $125.00 | $163.75 | $400.00 |
Cigna
| Facility | 26 | $83.32 | $83.32 | $83.32 |
Martin's Point
| Facility | 26 | $125.00 | $181.25 | $408.75 |
Priority Health
| Facility | 26 | $83.32 | $83.32 | $83.32 |
UPMC Health Plan
| Facility | 26 | $71.28 | $71.28 | $157.60 |