| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $82.90 | $99.60 | $632.46 |
Cigna
| Facility | 26 | $99.24 | $99.24 | $99.24 |
Martin's Point
| Facility | 26 | $82.90 | $118.55 | $632.46 |
Priority Health
| Facility | 26 | $99.24 | $99.24 | $99.24 |
UPMC Health Plan
| Facility | 26 | $85.66 | $85.66 | $111.00 |