| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $390.20 | $435.13 | $435.13 |
Cigna
| Facility | 26 | $462.59 | $462.59 | $462.59 |
Martin's Point
| Facility | 26 | $435.13 | $435.13 | $435.13 |
Priority Health
| Facility | 26 | $446.32 | $462.59 | $462.59 |
UPMC Health Plan
| Facility | 26 | $399.43 | $399.43 | $471.89 |