| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $85.00 | $85.00 | $85.00 | |
Cigna
| Facility | $50.00 | $50.00 | $104.00 | |
Martin's Point
| Facility | $85.00 | $85.00 | $85.00 | |
Priority Health
| Facility | $50.00 | $104.00 | $104.00 | |
UPMC Health Plan
| Facility | $108.00 | $108.00 | $152.33 |