| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $165.96 | $489.78 | $489.78 |
Cigna
| Facility | 26 | $38.02 | $177.83 | $257.04 |
Martin's Point
| Facility | 26 | $165.96 | $165.96 | $489.78 |
UPMC Health Plan
| Facility | 26 | $154.88 | $177.83 | $177.83 |