Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.15 / $154.75 / $154.75	Facility	26	$131.15	$154.75	$154.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.06 / $114.69 / $182.55	Professional		$63.06	$114.69	$182.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $30.52 / $43.50	Professional	26	$20.42	$30.52	$43.50
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $154.80 / $160.63 / $250.33	Professional		$154.80	$160.63	$250.33
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $36.89 / $38.28 / $63.37	Professional	26	$36.89	$38.28	$63.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.00 / $59.00 / $59.00	Facility	26	$59.00	$59.00	$59.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.87 / $80.19 / $175.25	Professional		$47.87	$80.19	$175.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.28 / $21.90 / $53.75	Professional	26	$17.28	$21.90	$53.75
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $101.66 / $235.05 / $311.79	Professional		$101.66	$235.05	$311.79
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.56 / $51.05 / $66.86	Professional	26	$22.56	$51.05	$66.86
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $154.75 / $154.75 / $154.75	Facility	26	$154.75	$154.75	$154.75
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $105.15 / $114.69 / $631.19	Professional		$105.15	$114.69	$631.19
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $25.06 / $30.52 / $154.75	Professional	26	$25.06	$30.52	$154.75
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $53.25 / $175.85 / $277.72	Professional		$53.25	$175.85	$277.72
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $59.00 / $59.00 / $59.00	Facility	26	$59.00	$59.00	$59.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $47.87 / $86.17 / $183.21	Professional		$47.87	$86.17	$183.21
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.39 / $32.97 / $56.32	Professional	26	$17.39	$32.97	$56.32
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $92.82 / $151.32 / $165.93	Professional		$92.82	$151.32	$165.93
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $37.27 / $38.22 / $41.73	Professional	26	$37.27	$38.22	$41.73
United Facility/Professional Professional Modifier Low / Median / High Price $67.59 / $133.33 / $191.04	Professional		$67.59	$133.33	$191.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.80 / $39.63 / $63.68	Professional	26	$21.80	$39.63	$63.68