Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.00 / $137.50 / $240.00	Facility	26	$125.00	$137.50	$240.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $172.50 / $531.92	Professional	26	$100.00	$172.50	$531.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $90.78 / $173.84 / $213.60	Professional	26	$90.78	$173.84	$213.60
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $131.36 / $144.32 / $3,412.57	Professional	26	$131.36	$144.32	$3,412.57
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $113.21 / $190.00 / $286.92	Professional	26	$113.21	$190.00	$286.92
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.81 / $128.81 / $128.81	Facility	26	$128.81	$128.81	$128.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.92 / $135.57 / $213.79	Professional	26	$80.92	$135.57	$213.79
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $148.36 / $148.36 / $166.42	Professional	26	$148.36	$148.36	$166.42
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $126.46 / $137.69 / $199.68	Professional	26	$126.46	$137.69	$199.68
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $131.36 / $140.08 / $3,412.57	Professional	26	$131.36	$140.08	$3,412.57
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $125.00 / $168.62 / $395.00	Facility	26	$125.00	$168.62	$395.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $108.68 / $169.87 / $360.00	Professional	26	$108.68	$169.87	$360.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $128.81 / $128.81 / $128.81	Facility	26	$128.81	$128.81	$128.81
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.31 / $140.63 / $222.31	Professional	26	$81.31	$140.63	$222.31
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $111.67 / $111.67 / $129.13	Facility	26	$111.67	$111.67	$129.13
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $108.86 / $111.68 / $129.13	Professional	26	$108.86	$111.68	$129.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $101.65 / $137.52 / $220.63	Professional	26	$101.65	$137.52	$220.63