Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $100.00 / $173.78	Facility	26	$37.15	$100.00	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $79.43 / $354.81	Professional		$45.71	$79.43	$354.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $38.02 / $83.18	Professional	26	$28.18	$38.02	$83.18
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $144.54 / $144.54 / $144.54	Professional	50	$144.54	$144.54	$144.54
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $57.54 / $162.18	Professional		$54.95	$57.54	$162.18
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $36.31 / $87.10	Professional	26	$34.67	$36.31	$87.10
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $109.65 / $114.82 / $323.59	Professional	50	$109.65	$114.82	$323.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $39.81 / $56.23	Facility	26	$8.51	$39.81	$56.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $104.71 / $177.83	Professional		$52.48	$104.71	$177.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $53.70 / $85.11	Professional	26	$29.51	$53.70	$85.11
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $79.43 / $95.50	Professional		$67.61	$79.43	$95.50
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $46.77 / $57.54	Professional	26	$30.20	$46.77	$57.54
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $95.50 / $162.18	Professional		$60.26	$95.50	$162.18
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $47.86 / $81.28	Professional	26	$36.31	$47.86	$81.28
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $93.33 / $173.78	Facility	26	$37.15	$93.33	$173.78
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $89.13 / $223.87	Professional		$47.86	$89.13	$223.87
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $45.71 / $97.72	Professional	26	$30.20	$45.71	$97.72
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $144.54 / $144.54 / $144.54	Professional	50	$144.54	$144.54	$144.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $123.03 / $199.53	Professional		$102.33	$123.03	$199.53
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $52.48 / $52.48	Facility	26	$34.67	$52.48	$52.48
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $54.95 / $125.89	Professional		$13.80	$54.95	$125.89
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $34.67 / $52.48	Professional	26	$34.67	$34.67	$52.48
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $74.13 / $138.04	Professional		$51.29	$74.13	$138.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $40.74 / $70.79	Professional	26	$30.90	$40.74	$70.79