Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.98 / $343.80 / $487.11	Facility		$69.98	$343.80	$487.11
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.59 / $51.32 / $54.51	Facility	26	$39.59	$51.32	$54.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.24 / $88.80 / $253.00	Professional		$42.24	$88.80	$253.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.18 / $56.14 / $106.42	Professional	26	$33.18	$56.14	$106.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.90 / $46.60 / $157.97	Professional	TC	$24.90	$46.60	$157.97
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,084.00 / $1,419.00 / $12,759.45	Facility		$1,084.00	$1,419.00	$12,759.45
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $66.45 / $68.83 / $124.18	Professional		$66.45	$68.83	$124.18
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $38.58 / $58.91 / $87.74	Professional	26	$38.58	$58.91	$87.74
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $27.88 / $42.46 / $108.71	Professional	TC	$27.88	$42.46	$108.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $71.95 / $71.95 / $71.95	Facility		$71.95	$71.95	$71.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.98 / $41.98 / $41.98	Facility	26	$41.98	$41.98	$41.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.07 / $192.66 / $339.61	Professional		$63.07	$192.66	$339.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.45 / $77.29 / $135.53	Professional	26	$35.45	$77.29	$135.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.38 / $113.20 / $210.72	Professional	TC	$27.38	$113.20	$210.72
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $65.56 / $95.94 / $128.44	Professional		$65.56	$95.94	$128.44
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.36 / $53.47 / $71.93	Professional	26	$36.36	$53.47	$71.93
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.21 / $42.47 / $55.14	Professional	TC	$29.21	$42.47	$55.14
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $152.80 / $237.94 / $614.59	Facility		$152.80	$237.94	$614.59
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $89.60 / $190.40 / $651.37	Facility		$89.60	$190.40	$651.37
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $39.59 / $52.01 / $54.51	Facility	26	$39.59	$52.01	$54.51
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $47.59 / $105.68 / $305.66	Professional		$47.59	$105.68	$305.66
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $33.31 / $60.71 / $116.97	Professional	26	$33.31	$60.71	$116.97
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $25.23 / $47.83 / $181.57	Professional	TC	$25.23	$47.83	$181.57
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $132.80 / $234.20 / $283.89	Professional		$132.80	$234.20	$283.89
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $71.95 / $71.95 / $219.17	Facility		$71.95	$71.95	$219.17
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $41.98 / $41.98 / $81.08	Facility	26	$41.98	$41.98	$81.08
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $63.07 / $165.00 / $339.61	Professional		$63.07	$165.00	$339.61
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.17 / $76.43 / $142.65	Professional	26	$36.17	$76.43	$142.65
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.38 / $63.85 / $210.72	Professional	TC	$27.38	$63.85	$210.72
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $62.02 / $62.02 / $204.96	Facility		$62.02	$62.02	$204.96
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $36.10 / $36.10 / $82.82	Facility	26	$36.10	$36.10	$82.82
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $60.75 / $62.02 / $66.05	Professional		$60.75	$62.02	$66.05
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $35.01 / $36.28 / $37.52	Professional	26	$35.01	$36.28	$37.52
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $25.39 / $25.92 / $28.54	Professional	TC	$25.39	$25.92	$28.54
United Facility/Professional Facility Modifier Low / Median / High Price $162.00 / $1,078.00 / $3,742.00	Facility		$162.00	$1,078.00	$3,742.00
United Facility/Professional Professional Modifier Low / Median / High Price $66.09 / $95.55 / $262.66	Professional		$66.09	$95.55	$262.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.42 / $54.56 / $102.54	Professional	26	$37.42	$54.56	$102.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.74 / $41.82 / $149.05	Professional	TC	$27.74	$41.82	$149.05