Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $177.83 / $251.19	Facility	26	$75.86	$177.83	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $97.72 / $177.83	Professional		$67.61	$97.72	$177.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $70.79 / $251.19	Professional	26	$54.95	$70.79	$251.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $53.70 / $53.70	Professional	26	$53.70	$53.70	$53.70
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $114.82 / $165.96	Professional		$93.33	$114.82	$165.96
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $85.11 / $123.03	Professional	26	$67.61	$85.11	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $141.25 / $295.12	Professional		$89.13	$141.25	$295.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $85.11 / $131.83	Professional	26	$54.95	$85.11	$131.83
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $134.90 / $158.49	Professional		$114.82	$134.90	$158.49
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $93.33 / $109.65	Professional	26	$79.43	$93.33	$109.65
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $158.49 / $302.00	Professional		$104.71	$158.49	$302.00
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $91.20 / $134.90	Professional	26	$63.10	$91.20	$134.90
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $177.83 / $239.88	Facility	26	$75.86	$177.83	$239.88
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $114.82 / $269.15	Professional		$77.62	$114.82	$269.15
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $77.62 / $245.47	Professional	26	$56.23	$77.62	$245.47
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $173.78 / $389.05	Professional		$144.54	$173.78	$389.05
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $66.07 / $91.20 / $91.20	Facility	26	$66.07	$91.20	$91.20
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $91.20 / $346.74	Professional		$20.42	$91.20	$346.74
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $67.61 / $91.20	Professional	26	$64.57	$67.61	$91.20
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $114.82 / $251.19	Professional		$77.62	$114.82	$251.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $72.44 / $120.23	Professional	26	$54.95	$72.44	$120.23