| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Geisinger
| Facility | $19.05 | $19.05 | $19.05 | |
UPMC Health Plan
| Facility | $17.38 | $17.78 | $21.38 | |
UPMC Health Plan
| Professional | $17.38 | $17.78 | $21.38 | |
United
| Professional | $19.95 | $19.95 | $27.54 |