| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $576.15 | $576.15 | $576.15 | |
Cigna
| Facility | $691.08 | $691.08 | $691.08 | |
Emblem Health
| Facility | $1,312.31 | $1,312.31 | $1,312.31 | |
Priority Health
| Facility | $691.08 | $691.08 | $691.08 | |
UPMC Health Plan
| Facility | $592.70 | $592.70 | $592.70 |