Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $112.20 / $302.00	Facility	26	$46.77	$112.20	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $83.18 / $181.97	Professional		$64.57	$83.18	$181.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $46.77 / $123.03	Professional	26	$38.02	$46.77	$123.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $57.54 / $57.54	Professional	26	$57.54	$57.54	$57.54
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $77.62 / $125.89	Professional		$64.57	$77.62	$125.89
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $42.66 / $79.43	Professional	26	$36.31	$42.66	$79.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $46.77 / $66.07	Facility	26	$10.00	$46.77	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $87.10 / $151.36	Professional		$69.18	$87.10	$151.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $54.95 / $91.20	Professional	26	$39.81	$54.95	$91.20
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $114.82 / $151.36	Professional		$89.13	$114.82	$151.36
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $60.26 / $79.43	Professional	26	$46.77	$60.26	$79.43
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $97.72 / $158.49	Professional		$69.18	$97.72	$158.49
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $54.95 / $87.10	Professional	26	$41.69	$54.95	$87.10
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $69.18 / $302.00	Facility	26	$46.77	$69.18	$302.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $95.50 / $204.17	Professional		$64.57	$95.50	$204.17
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $54.95 / $120.23	Professional	26	$38.90	$54.95	$120.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $112.20 / $204.17	Professional		$87.10	$112.20	$204.17
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $40.74 / $48.98	Facility	26	$40.74	$40.74	$48.98
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $74.13 / $131.83	Professional		$26.92	$74.13	$131.83
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $40.74 / $48.98	Professional	26	$39.81	$40.74	$48.98
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $85.11 / $134.90	Professional		$64.57	$85.11	$134.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $53.70 / $85.11	Professional	26	$38.02	$53.70	$85.11