| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $125.89 | $125.89 | $158.49 | |
UPMC Health Plan
| Facility | $44.67 | $114.82 | $125.89 | |
UPMC Health Plan
| Professional | $44.67 | $102.33 | $134.90 | |
United
| Facility | $45.71 | $54.95 | $63.10 |