| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $95.70 | $114.88 | $729.49 |
Cigna
| Facility | 26 | $114.78 | $114.78 | $114.78 |
Martin's Point
| Facility | 26 | $95.70 | $136.85 | $729.49 |
Priority Health
| Facility | 26 | $114.78 | $114.78 | $114.78 |
UPMC Health Plan
| Facility | 26 | $99.31 | $99.31 | $128.00 |