| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $85.11 | $120.23 | $144.54 | |
Capital Blue Cross
| Professional | $107.15 | $128.82 | $218.78 | |
Cigna
| Professional | $109.65 | $109.65 | $109.65 | |
Geisinger
| Professional | $93.33 | $107.15 | $154.88 | |
Martin's Point
| Professional | $89.13 | $123.03 | $154.88 | |
UPMC Health Plan
| Professional | $117.49 | $141.25 | $478.63 | |
United
| Professional | $112.20 | $154.88 | $239.88 |