Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $536.00 / $2,240.00 / $7,197.00	Facility		$536.00	$2,240.00	$7,197.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $132.88 / $132.88 / $184.41	Facility	26	$132.88	$132.88	$184.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $341.43 / $385.34 / $628.27	Professional		$341.43	$385.34	$628.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.41 / $132.90 / $284.36	Professional	26	$111.41	$132.90	$284.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $205.37 / $243.67 / $406.52	Professional	TC	$205.37	$243.67	$406.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $647.14 / $647.14 / $647.14	Professional		$647.14	$647.14	$647.14
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $2,299.82 / $2,746.00 / $13,822.74	Facility		$2,299.82	$2,746.00	$13,822.74
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $348.26 / $361.40 / $627.38	Professional		$348.26	$361.40	$627.38
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $124.82 / $200.05 / $249.89	Professional	26	$124.82	$200.05	$249.89
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $223.44 / $348.59 / $408.59	Professional	TC	$223.44	$348.59	$408.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $342.83 / $449.59 / $709.69	Professional		$342.83	$449.59	$709.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $129.53 / $167.93 / $260.76	Professional	26	$129.53	$167.93	$260.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $208.90 / $284.57 / $476.43	Professional	TC	$208.90	$284.57	$476.43
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $422.67 / $560.33 / $576.72	Professional		$422.67	$560.33	$576.72
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $143.77 / $189.91 / $190.49	Professional	26	$143.77	$189.91	$190.49
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $278.89 / $370.41 / $386.24	Professional	TC	$278.89	$370.41	$386.24
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,812.76 / $2,697.38 / $9,102.54	Facility		$1,812.76	$2,697.38	$9,102.54
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $561.04 / $2,326.00 / $7,799.00	Facility		$561.04	$2,326.00	$7,799.00
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $132.88 / $177.80 / $184.41	Facility	26	$132.88	$177.80	$184.41
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $341.43 / $496.11 / $930.17	Professional		$341.43	$496.11	$930.17
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $118.99 / $176.02 / $298.45	Professional	26	$118.99	$176.02	$298.45
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $214.11 / $290.89 / $597.52	Professional	TC	$214.11	$290.89	$597.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.00 / $387.00 / $1,058.90	Professional		$3.00	$387.00	$1,058.90
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $342.83 / $452.10 / $741.70	Professional		$342.83	$452.10	$741.70
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $132.96 / $172.17 / $288.61	Professional	26	$132.96	$172.17	$288.61
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $208.90 / $299.91 / $480.43	Professional	TC	$208.90	$299.91	$480.43
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $275.89 / $371.56 / $371.56	Facility		$275.89	$371.56	$371.56
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $115.67 / $122.13 / $122.13	Facility	26	$115.67	$122.13	$122.13
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $275.89 / $371.56 / $401.60	Professional		$275.89	$371.56	$401.60
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $115.67 / $122.13 / $127.01	Professional	26	$115.67	$122.13	$127.01
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $160.22 / $249.44 / $274.58	Professional	TC	$160.22	$249.44	$274.58
United Facility/Professional Facility Modifier Low / Median / High Price $471.00 / $1,305.00 / $3,742.00	Facility		$471.00	$1,305.00	$3,742.00
United Facility/Professional Professional Modifier Low / Median / High Price $319.11 / $459.97 / $724.10	Professional		$319.11	$459.97	$724.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $127.01 / $156.44 / $256.04	Professional	26	$127.01	$156.44	$256.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $173.53 / $281.27 / $474.37	Professional	TC	$173.53	$281.27	$474.37