| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $83.71 | $101.11 | $642.04 |
Cigna
| Facility | 26 | $100.40 | $100.40 | $100.40 |
Martin's Point
| Facility | 26 | $83.71 | $119.71 | $642.04 |
Priority Health
| Facility | 26 | $100.40 | $100.40 | $100.40 |
UPMC Health Plan
| Facility | 26 | $74.00 | $87.19 | $87.19 |