| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Geisinger
| Facility | $12.88 | $12.88 | $12.88 | |
Geisinger
| Professional | $4.79 | $4.79 | $4.79 | |
UPMC Health Plan
| Facility | $5.89 | $6.92 | $6.92 | |
UPMC Health Plan
| Professional | $5.89 | $6.46 | $7.94 |