| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $537.03 | $537.03 | $537.03 | |
Capital Blue Cross
| Facility | $10.96 | $12.88 | $5,011.87 | |
Capital Blue Cross
| Professional | $12.88 | $12.88 | $12.88 | |
Martin's Point
| Professional | $537.03 | $537.03 | $537.03 | |
UPMC Health Plan
| Facility | $20.42 | $31.62 | $91.20 | |
UPMC Health Plan
| Professional | $20.42 | $31.62 | $91.20 | |
United
| Professional | $14.13 | $14.13 | $14.13 |