Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $245.47 / $501.19	Facility	26	$109.65	$245.47	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $478.63 / $1,023.29	Professional		$398.11	$478.63	$1,023.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $112.20 / $229.09	Professional	26	$70.79	$112.20	$229.09
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $575.44 / $724.44	Professional		$575.44	$575.44	$724.44
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $93.33 / $134.90	Professional	26	$70.79	$93.33	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $549.54 / $812.83	Professional		$338.84	$549.54	$812.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $91.20 / $138.04	Professional	26	$57.54	$91.20	$138.04
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $616.60 / $724.44	Professional		$512.86	$616.60	$724.44
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $95.50 / $114.82	Professional	26	$81.28	$95.50	$114.82
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $549.54 / $776.25	Professional		$338.84	$549.54	$776.25
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $95.50 / $151.36	Professional	26	$69.18	$95.50	$151.36
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $204.17 / $467.74	Facility	26	$102.33	$204.17	$467.74
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $549.54 / $1,479.11	Professional		$398.11	$549.54	$1,479.11
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $123.03 / $239.88	Professional	26	$70.79	$123.03	$239.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $741.31 / $831.76	Professional		$645.65	$741.31	$831.76
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $81.28 / $81.28	Facility	26	$69.18	$81.28	$81.28
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $398.11 / $512.86	Professional		$125.89	$398.11	$512.86
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $69.18 / $81.28	Professional	26	$67.61	$69.18	$81.28
United Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $467.74 / $812.83	Professional		$389.05	$467.74	$812.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $75.86 / $131.83	Professional	26	$63.10	$75.86	$131.83