Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.33 / $119.98 / $183.60	Facility	26	$100.33	$119.98	$183.60
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $44.50 / $55.79 / $354.29	Facility	53	$44.50	$55.79	$354.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $222.47 / $330.43 / $514.74	Professional		$222.47	$330.43	$514.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.98 / $122.56 / $471.00	Professional	26	$97.98	$122.56	$471.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $98.98 / $151.37 / $197.96	Professional	26	$98.98	$151.37	$197.96
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $124.07 / $135.65 / $141.29	Professional	26	$124.07	$135.65	$141.29
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $227.29 / $374.02 / $475.21	Professional		$227.29	$374.02	$475.21
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $104.92 / $170.01 / $259.99	Professional	26	$104.92	$170.01	$259.99
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $120.36 / $120.36 / $120.36	Facility	26	$120.36	$120.36	$120.36
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $52.64 / $52.64 / $52.64	Facility	53	$52.64	$52.64	$52.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $240.02 / $348.39 / $549.10	Professional		$240.02	$348.39	$549.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.67 / $140.77 / $231.81	Professional	26	$103.67	$140.77	$231.81
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $285.80 / $355.83 / $720.07	Professional		$285.80	$355.83	$720.07
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $125.21 / $152.56 / $308.72	Professional	26	$125.21	$152.56	$308.72
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $137.90 / $138.58 / $144.21	Professional	26	$137.90	$138.58	$144.21
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $130.81 / $136.09 / $222.57	Professional	26	$130.81	$136.09	$222.57
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $100.32 / $131.97 / $237.56	Facility	26	$100.32	$131.97	$237.56
Martin's Point Facility/Professional Facility Modifier 53 Low / Median / High Price $44.50 / $66.73 / $354.29	Facility	53	$44.50	$66.73	$354.29
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $222.48 / $337.47 / $806.46	Professional		$222.48	$337.47	$806.46
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $100.32 / $144.00 / $444.00	Professional	26	$100.32	$144.00	$444.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $150.38 / $330.80 / $562.60	Professional		$150.38	$330.80	$562.60
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $120.36 / $120.36 / $120.36	Facility	26	$120.36	$120.36	$120.36
Priority Health Facility/Professional Facility Modifier 53 Low / Median / High Price $52.64 / $52.64 / $52.64	Facility	53	$52.64	$52.64	$52.64
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $240.02 / $341.69 / $539.00	Professional		$240.02	$341.69	$539.00
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.58 / $140.01 / $237.47	Professional	26	$102.58	$140.01	$237.47
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $103.79 / $103.79 / $144.35	Facility	26	$103.79	$103.79	$144.35
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $225.16 / $228.34 / $383.00	Professional		$225.16	$228.34	$383.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $101.29 / $103.79 / $144.35	Professional	26	$101.29	$103.79	$144.35
United Facility/Professional Professional Modifier Low / Median / High Price $240.68 / $320.27 / $500.07	Professional		$240.68	$320.27	$500.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $105.71 / $136.60 / $219.87	Professional	26	$105.71	$136.60	$219.87