Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.52 / $155.74 / $403.20	Facility	26	$117.52	$155.74	$403.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $279.88 / $402.08 / $546.25	Professional		$279.88	$402.08	$546.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.08 / $126.00 / $389.19	Professional	26	$85.08	$126.00	$389.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $164.73 / $164.73 / $164.73	Professional		$164.73	$164.73	$164.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.89 / $64.91 / $78.89	Professional	26	$63.89	$64.91	$78.89
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $267.94 / $278.05 / $586.95	Professional		$267.94	$278.05	$586.95
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $84.23 / $87.41 / $166.43	Professional	26	$84.23	$87.41	$166.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.46 / $96.46 / $96.46	Facility	26	$96.46	$96.46	$96.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $241.30 / $516.12 / $915.23	Professional		$241.30	$516.12	$915.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.01 / $106.52 / $172.38	Professional	26	$63.01	$106.52	$172.38
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $323.07 / $428.60 / $1,426.39	Professional		$323.07	$428.60	$1,426.39
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $92.18 / $110.71 / $174.72	Professional	26	$92.18	$110.71	$174.72
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.78 / $111.08 / $805.35	Professional	26	$93.78	$111.08	$805.35
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $117.52 / $165.06 / $412.02	Facility	26	$117.52	$165.06	$412.02
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $282.70 / $425.00 / $1,362.00	Professional		$282.70	$425.00	$1,362.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $85.16 / $126.00 / $307.44	Professional	26	$85.16	$126.00	$307.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $97.14 / $280.47 / $700.00	Professional		$97.14	$280.47	$700.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $96.46 / $96.46	Facility	26	$63.10	$96.46	$96.46
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $252.77 / $490.83 / $873.26	Professional		$252.77	$490.83	$873.26
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.96 / $106.73 / $172.38	Professional	26	$63.96	$106.73	$172.38
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $83.94 / $83.94 / $105.00	Facility	26	$83.94	$83.94	$105.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $269.85 / $273.94 / $615.00	Professional		$269.85	$273.94	$615.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $81.76 / $84.01 / $105.00	Professional	26	$81.76	$84.01	$105.00
United Facility/Professional Professional Modifier Low / Median / High Price $272.16 / $393.12 / $700.90	Professional		$272.16	$393.12	$700.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.02 / $99.40 / $167.94	Professional	26	$78.02	$99.40	$167.94