| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $67.61 | $67.61 | $123.03 | |
Capital Blue Cross
| Professional | $85.11 | $85.11 | $87.10 | |
Cigna
| Facility | $30.90 | $30.90 | $30.90 | |
Cigna
| Professional | $26.30 | $30.90 | $870.96 | |
Martin's Point
| Professional | $67.61 | $67.61 | $79.43 | |
UPMC Health Plan
| Professional | $331.13 | $331.13 | $331.13 |