Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.29 / $107.02 / $285.32	Facility	26	$90.29	$107.02	$285.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.82 / $169.49 / $303.42	Professional		$141.82	$169.49	$303.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.34 / $83.45 / $167.97	Professional	26	$49.34	$83.45	$167.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $147.59 / $147.59 / $177.58	Professional	26	$147.59	$147.59	$177.58
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $167.85 / $174.18 / $284.26	Professional		$167.85	$174.18	$284.26
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $88.74 / $97.67 / $152.38	Professional	26	$88.74	$97.67	$152.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.98 / $106.98 / $106.98	Facility	26	$106.98	$106.98	$106.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.88 / $261.43 / $611.17	Professional		$135.88	$261.43	$611.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.52 / $79.11 / $161.38	Professional	26	$54.52	$79.11	$161.38
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $198.15 / $243.12 / $462.30	Professional		$198.15	$243.12	$462.30
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $103.11 / $122.83 / $194.06	Professional	26	$103.11	$122.83	$194.06
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.66 / $107.66 / $107.66	Professional		$107.66	$107.66	$107.66
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $101.93 / $113.89 / $154.61	Professional	26	$101.93	$113.89	$154.61
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $90.29 / $120.64 / $295.25	Facility	26	$90.29	$120.64	$295.25
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $148.91 / $209.52 / $472.48	Professional		$148.91	$209.52	$472.48
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $54.71 / $91.41 / $193.22	Professional	26	$54.71	$91.41	$193.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $145.52 / $676.50 / $727.40	Professional		$145.52	$676.50	$727.40
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $37.25 / $106.98 / $106.98	Facility	26	$37.25	$106.98	$106.98
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $136.08 / $255.83 / $601.91	Professional		$136.08	$255.83	$601.91
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.52 / $79.48 / $160.99	Professional	26	$54.52	$79.48	$160.99
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $93.03 / $93.03 / $94.00	Facility	26	$93.03	$93.03	$94.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $163.38 / $166.67 / $523.85	Professional		$163.38	$166.67	$523.85
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $90.20 / $93.52 / $96.31	Professional	26	$90.20	$93.52	$96.31
United Facility/Professional Professional Modifier Low / Median / High Price $162.55 / $234.79 / $471.61	Professional		$162.55	$234.79	$471.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.82 / $100.33 / $182.24	Professional	26	$55.82	$100.33	$182.24