Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.33 / $108.29 / $234.43	Facility	26	$67.33	$108.29	$234.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.05 / $171.34 / $304.55	Professional		$144.05	$171.34	$304.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.75 / $72.93 / $118.85	Professional	26	$62.75	$72.93	$118.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $130.82 / $130.82 / $143.63	Professional		$130.82	$130.82	$143.63
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $170.43 / $211.81 / $307.23	Professional		$170.43	$211.81	$307.23
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $76.02 / $98.33 / $144.69	Professional	26	$76.02	$98.33	$144.69
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.87 / $86.87 / $86.87	Facility	26	$86.87	$86.87	$86.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.66 / $210.22 / $329.29	Professional		$136.66	$210.22	$329.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.96 / $95.16 / $151.15	Professional	26	$60.96	$95.16	$151.15
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $196.34 / $241.15 / $412.34	Professional		$196.34	$241.15	$412.34
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $86.32 / $109.81 / $171.58	Professional	26	$86.32	$109.81	$171.58
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $73.26 / $113.12 / $239.56	Facility	26	$73.26	$113.12	$239.56
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $148.34 / $183.11 / $421.00	Professional		$148.34	$183.11	$421.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $63.54 / $77.73 / $186.50	Professional	26	$63.54	$77.73	$186.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $195.40 / $207.20 / $433.60	Professional		$195.40	$207.20	$433.60
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $86.87 / $86.87 / $86.87	Facility	26	$86.87	$86.87	$86.87
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $139.49 / $209.01 / $329.29	Professional		$139.49	$209.01	$329.29
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.32 / $94.96 / $151.15	Professional	26	$61.32	$94.96	$151.15
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $74.92 / $74.92 / $78.17	Facility	26	$74.92	$74.92	$78.17
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $150.85 / $168.80 / $181.16	Professional		$150.85	$168.80	$181.16
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $73.17 / $74.92 / $78.17	Professional	26	$73.17	$74.92	$78.17
United Facility/Professional Professional Modifier Low / Median / High Price $136.86 / $186.32 / $316.00	Professional		$136.86	$186.32	$316.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.91 / $86.50 / $148.65	Professional	26	$62.91	$86.50	$148.65