| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Capital Blue Cross
| Facility | $9.36 | $11.01 | $8,639.91 | |
Capital Blue Cross
| Professional | $11.01 | $11.01 | $11.01 | |
UPMC Health Plan
| Facility | $31.72 | $31.72 | $31.72 | |
UPMC Health Plan
| Professional | $31.72 | $31.72 | $31.72 |