| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $34.28 | $34.28 | $42.85 | |
Priority Health
| Professional | $34.28 | $34.28 | $42.85 | |
UPMC Health Plan
| Facility | $29.92 | $29.92 | $32.29 | |
UPMC Health Plan
| Professional | $26.33 | $29.92 | $32.29 |