| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Capital Blue Cross
| Facility | $6.35 | $7.47 | $8,639.91 | |
Capital Blue Cross
| Professional | $7.47 | $7.47 | $7.47 | |
UPMC Health Plan
| Facility | $84.77 | $84.77 | $84.77 | |
UPMC Health Plan
| Professional | $84.77 | $84.77 | $84.77 |