Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $114.82 / $218.78	Facility	26	$57.54	$114.82	$218.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $229.09 / $724.44	Professional		$173.78	$229.09	$724.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $70.79 / $141.25	Professional	26	$44.67	$70.79	$141.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $85.11 / $85.11	Professional	26	$85.11	$85.11	$85.11
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $213.80 / $380.19	Professional		$208.93	$213.80	$380.19
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $61.66 / $104.71	Professional	26	$58.88	$61.66	$104.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $67.61 / $97.72	Facility	26	$14.45	$67.61	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $239.88 / $416.87	Professional		$151.36	$239.88	$416.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $64.57 / $117.49	Professional	26	$42.66	$64.57	$117.49
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $288.40 / $363.08	Professional		$223.87	$288.40	$363.08
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $77.62 / $93.33	Professional	26	$58.88	$77.62	$93.33
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $218.78 / $436.52	Professional		$104.71	$218.78	$436.52
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $63.10 / $123.03	Professional	26	$39.81	$63.10	$123.03
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $61.66 / $69.18	Professional	26	$54.95	$61.66	$69.18
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $107.15 / $190.55	Facility	26	$58.88	$107.15	$190.55
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $251.19 / $524.81	Professional		$181.97	$251.19	$524.81
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $70.79 / $138.04	Professional	26	$46.77	$70.79	$138.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $346.74 / $467.74	Professional		$169.82	$346.74	$467.74
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $52.48 / $58.88	Facility	26	$52.48	$52.48	$58.88
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $91.20 / $234.42	Professional		$28.84	$91.20	$234.42
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $58.88 / $61.66	Professional	26	$52.48	$58.88	$61.66
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $218.78 / $380.19	Professional		$138.04	$218.78	$380.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $61.66 / $104.71	Professional	26	$43.65	$61.66	$104.71