Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.98 / $44.46 / $113.70	Facility	26	$30.98	$44.46	$113.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.69 / $77.45 / $284.94	Professional		$46.69	$77.45	$284.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.23 / $34.11 / $53.49	Professional	26	$29.23	$34.11	$53.49
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $55.31 / $79.75 / $181.99	Professional		$55.31	$79.75	$181.99
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $34.97 / $45.33 / $97.55	Professional	26	$34.97	$45.33	$97.55
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $110.62 / $159.51 / $363.97	Professional	50	$110.62	$159.51	$363.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.95 / $39.95 / $39.95	Facility	26	$39.95	$39.95	$39.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.56 / $103.00 / $178.21	Professional		$52.56	$103.00	$178.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.36 / $55.69 / $90.65	Professional	26	$29.36	$55.69	$90.65
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $88.33 / $88.33 / $100.97	Professional	50	$88.33	$88.33	$100.97
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $65.25 / $85.65 / $131.58	Professional		$65.25	$85.65	$131.58
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.01 / $50.85 / $79.44	Professional	26	$40.01	$50.85	$79.44
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $33.94 / $63.47 / $134.06	Facility	26	$33.94	$63.47	$134.06
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $48.68 / $89.23 / $292.07	Professional		$48.68	$89.23	$292.07
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $29.80 / $39.38 / $100.80	Professional	26	$29.80	$39.38	$100.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $117.50 / $123.70 / $188.80	Professional		$117.50	$123.70	$188.80
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $39.95 / $39.95 / $39.95	Facility	26	$39.95	$39.95	$39.95
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $54.55 / $100.89 / $176.71	Professional		$54.55	$100.89	$176.71
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.59 / $54.53 / $85.66	Professional	26	$30.59	$54.53	$85.66
Priority Health Facility/Professional Professional Modifier 50 Low / Median / High Price $88.33 / $100.97 / $100.97	Professional	50	$88.33	$100.97	$100.97
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $34.64 / $34.64 / $52.00	Facility	26	$34.64	$34.64	$52.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $54.38 / $55.18 / $125.00	Professional		$54.38	$55.18	$125.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $33.99 / $34.64 / $52.00	Professional	26	$33.99	$34.64	$52.00
United Facility/Professional Professional Modifier Low / Median / High Price $54.59 / $75.81 / $138.72	Professional		$54.59	$75.81	$138.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $43.59 / $71.00	Professional	26	$32.36	$43.59	$71.00