Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.11 / $52.10 / $125.18	Facility	26	$39.11	$52.10	$125.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.25 / $95.82 / $145.44	Professional		$81.25	$95.82	$145.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.69 / $38.02 / $56.03	Professional	26	$32.69	$38.02	$56.03
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $108.58 / $112.67 / $171.37	Professional		$108.58	$112.67	$171.37
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $41.83 / $43.41 / $79.87	Professional	26	$41.83	$43.41	$79.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.27 / $47.27 / $47.27	Facility	26	$47.27	$47.27	$47.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.95 / $128.22 / $201.07	Professional		$81.95	$128.22	$201.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.72 / $50.25 / $78.98	Professional	26	$30.72	$50.25	$78.98
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $107.79 / $150.71 / $172.34	Professional		$107.79	$150.71	$172.34
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.95 / $55.40 / $87.01	Professional	26	$45.95	$55.40	$87.01
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $39.11 / $73.15 / $127.92	Facility	26	$39.11	$73.15	$127.92
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $86.85 / $103.39 / $225.38	Professional		$86.85	$103.39	$225.38
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $33.90 / $39.56 / $83.71	Professional	26	$33.90	$39.56	$83.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $153.90 / $153.90 / $281.50	Professional		$153.90	$153.90	$281.50
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $27.73 / $47.27 / $47.27	Facility	26	$27.73	$47.27	$47.27
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $84.45 / $128.04 / $200.75	Professional		$84.45	$128.04	$200.75
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.36 / $49.87 / $79.34	Professional	26	$31.36	$49.87	$79.34
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $40.44 / $40.44 / $45.00	Facility	26	$40.44	$40.44	$45.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $103.20 / $104.62 / $125.50	Professional		$103.20	$104.62	$125.50
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $39.45 / $40.44 / $45.00	Professional	26	$39.45	$40.44	$45.00
United Facility/Professional Professional Modifier Low / Median / High Price $93.99 / $118.10 / $197.40	Professional		$93.99	$118.10	$197.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.59 / $45.84 / $81.53	Professional	26	$38.59	$45.84	$81.53