Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $100.00 / $213.80	Facility	26	$64.57	$100.00	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $173.78 / $371.54	Professional		$144.54	$173.78	$371.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $95.50 / $288.40	Professional	26	$64.57	$95.50	$288.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $144.54 / $199.53	Professional		$131.83	$144.54	$199.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $83.18 / $125.89	Professional	26	$72.44	$83.18	$125.89
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $158.49 / $257.04	Professional		$134.90	$158.49	$257.04
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $69.18 / $114.82	Professional	26	$58.88	$69.18	$114.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.22 / $75.86 / $109.65	Facility	26	$16.22	$75.86	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $186.21 / $338.84	Professional		$147.91	$186.21	$338.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $83.18 / $141.25	Professional	26	$64.57	$83.18	$141.25
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $234.42 / $331.13	Professional		$173.78	$234.42	$331.13
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $93.33 / $134.90	Professional	26	$69.18	$93.33	$134.90
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $173.78 / $288.40	Professional		$141.25	$173.78	$288.40
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $79.43 / $120.23	Professional	26	$69.18	$79.43	$120.23
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $162.18 / $190.55	Professional		$74.13	$162.18	$190.55
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $81.28 / $114.82	Professional	26	$45.71	$81.28	$114.82
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $100.00 / $144.54	Facility	26	$64.57	$100.00	$144.54
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $204.17 / $407.38	Professional		$144.54	$204.17	$407.38
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $97.72 / $213.80	Professional	26	$64.57	$97.72	$213.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $295.12 / $389.05	Professional		$165.96	$295.12	$389.05
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $66.07 / $66.07 / $70.79	Facility	26	$66.07	$66.07	$70.79
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $144.54 / $323.59	Professional		$39.81	$144.54	$323.59
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $67.61 / $69.18	Professional	26	$66.07	$67.61	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $165.96 / $281.84	Professional		$128.82	$165.96	$281.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $74.13 / $125.89	Professional	26	$57.54	$74.13	$125.89