| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.70 | $416.87 | $467.74 | |
Capital Blue Cross
| Facility | $5,011.87 | $8,511.38 | $77,624.71 | |
Martin's Point
| Facility | $25.70 | $416.87 | $602.56 | |
UPMC Health Plan
| Facility | $33.11 | $54.95 | $218.78 | |
United
| Facility | $616.60 | $1,174.90 | $1,445.44 |