| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Capital Blue Cross
| Professional | $64,999.35 | $64,999.35 | $64,999.35 | |
Cigna
| Facility | $85.90 | $85.90 | $85.90 | |
Priority Health
| Facility | $85.90 | $85.90 | $85.90 | |
UPMC Health Plan
| Professional | $1.33 | $1.33 | $1.33 |