| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Geisinger
| Professional | $11.75 | $11.75 | $11.75 | |
UPMC Health Plan
| Facility | $6.03 | $6.92 | $8.13 | |
UPMC Health Plan
| Professional | $6.03 | $7.24 | $23.99 | |
United
| Facility | $6.03 | $6.03 | $6.03 | |
United
| Professional | $6.03 | $6.03 | $8.32 |