| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $128.82 | $158.49 | $309.03 | |
Capital Blue Cross
| Professional | $117.49 | $138.04 | $302.00 | |
Cigna
| Professional | $128.82 | $162.18 | $323.59 | |
Geisinger
| Professional | $199.53 | $234.42 | $234.42 | |
Martin's Point
| Professional | $131.83 | $177.83 | $467.74 | |
UPMC Health Plan
| Professional | $14.13 | $95.50 | $478.63 | |
United
| Professional | $144.54 | $186.21 | $302.00 |