Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.34 / $134.29 / $1,142.76	Facility	26	$88.34	$134.29	$1,142.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $153.50 / $244.99 / $896.55	Professional		$153.50	$244.99	$896.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.69 / $115.02 / $252.69	Professional	26	$76.69	$115.02	$252.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.08 / $266.94 / $272.62	Professional		$141.08	$266.94	$272.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $109.90 / $137.61 / $164.85	Professional	26	$109.90	$137.61	$164.85
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $219.48 / $239.08 / $632.29	Professional		$219.48	$239.08	$632.29
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $116.52 / $143.28 / $249.48	Professional	26	$116.52	$143.28	$249.48
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $173.84 / $279.87 / $539.79	Professional		$173.84	$279.87	$539.79
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $89.61 / $150.94 / $228.02	Professional	26	$89.61	$150.94	$228.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.92 / $102.92 / $102.92	Facility	26	$102.92	$102.92	$102.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $148.16 / $244.11 / $389.45	Professional		$148.16	$244.11	$389.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.88 / $116.53 / $181.32	Professional	26	$72.88	$116.53	$181.32
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $205.33 / $243.41 / $521.50	Professional		$205.33	$243.41	$521.50
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $101.24 / $128.43 / $251.24	Professional	26	$101.24	$128.43	$251.24
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $195.35 / $225.70 / $331.22	Professional		$195.35	$225.70	$331.22
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $98.04 / $127.55 / $166.44	Professional	26	$98.04	$127.55	$166.44
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $179.70 / $245.82 / $632.29	Professional		$179.70	$245.82	$632.29
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $112.04 / $127.48 / $249.48	Professional	26	$112.04	$127.48	$249.48
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $88.34 / $140.34 / $295.97	Facility	26	$88.34	$140.34	$295.97
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $165.34 / $268.00 / $561.15	Professional		$165.34	$268.00	$561.15
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $81.26 / $133.00 / $262.39	Professional	26	$81.26	$133.00	$262.39
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $87.08 / $177.31 / $344.50	Professional		$87.08	$177.31	$344.50
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $102.92 / $102.92 / $102.92	Facility	26	$102.92	$102.92	$102.92
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $148.16 / $237.67 / $373.19	Professional		$148.16	$237.67	$373.19
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $73.95 / $117.27 / $181.32	Professional	26	$73.95	$117.27	$181.32
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $89.01 / $89.01 / $128.00	Facility	26	$89.01	$89.01	$128.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $168.33 / $170.86 / $292.00	Professional		$168.33	$170.86	$292.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $87.09 / $89.01 / $128.00	Professional	26	$87.09	$89.01	$128.00
United Facility/Professional Professional Modifier Low / Median / High Price $151.88 / $204.15 / $328.53	Professional		$151.88	$204.15	$328.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.00 / $102.74 / $174.57	Professional	26	$76.00	$102.74	$174.57