| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $173.72 | $194.11 | $194.11 |
Cigna
| Facility | 26 | $194.40 | $194.40 | $194.40 |
Martin's Point
| Facility | 26 | $194.11 | $194.11 | $194.11 |
Priority Health
| Facility | 26 | $180.37 | $194.40 | $194.40 |
UPMC Health Plan
| Facility | 26 | $178.50 | $178.50 | $182.46 |