| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $9.60 | $9.60 | $9.60 | |
Capital Blue Cross
| Facility | $12.72 | $14.96 | $8,639.91 | |
Capital Blue Cross
| Professional | $14.96 | $14.96 | $14.96 | |
Martin's Point
| Professional | $9.60 | $9.60 | $9.60 | |
UPMC Health Plan
| Facility | $11.37 | $29.93 | $29.93 | |
UPMC Health Plan
| Professional | $11.37 | $11.37 | $29.93 | |
United
| Professional | $15.75 | $15.75 | $28.82 |