Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $249.55 / $1,746.00 / $7,175.00	Facility		$249.55	$1,746.00	$7,175.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.11 / $42.11 / $58.48	Facility	26	$42.11	$42.11	$58.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.13 / $220.51 / $538.80	Professional		$140.13	$220.51	$538.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.32 / $43.81 / $117.12	Professional	26	$35.32	$43.81	$117.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $94.17 / $139.21 / $220.72	Professional	TC	$94.17	$139.21	$220.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $298.88 / $298.88 / $298.88	Professional		$298.88	$298.88	$298.88
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,083.51 / $1,395.00 / $12,759.45	Facility		$1,083.51	$1,395.00	$12,759.45
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $160.28 / $169.17 / $212.47	Professional		$160.28	$169.17	$212.47
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $39.19 / $63.44 / $75.41	Professional	26	$39.19	$63.44	$75.41
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $106.81 / $125.66 / $238.74	Professional	TC	$106.81	$125.66	$238.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $148.13 / $222.13 / $407.05	Professional		$148.13	$222.13	$407.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.65 / $59.04 / $108.10	Professional	26	$40.65	$59.04	$108.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $96.39 / $167.52 / $310.63	Professional	TC	$96.39	$167.52	$310.63
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $259.18 / $287.50	Professional		$30.00	$259.18	$287.50
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.75 / $58.94 / $59.80	Professional	26	$44.75	$58.94	$59.80
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $150.88 / $200.24 / $209.44	Professional	TC	$150.88	$200.24	$209.44
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $105.20 / $235.98 / $561.22	Facility		$105.20	$235.98	$561.22
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $278.57 / $1,819.00 / $7,197.00	Facility		$278.57	$1,819.00	$7,197.00
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $42.11 / $55.82 / $58.48	Facility	26	$42.11	$55.82	$58.48
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $152.68 / $241.17 / $550.58	Professional		$152.68	$241.17	$550.58
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $36.97 / $58.03 / $117.12	Professional	26	$36.97	$58.03	$117.12
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $98.17 / $153.13 / $337.17	Professional	TC	$98.17	$153.13	$337.17
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $209.00 / $313.30 / $541.79	Professional		$209.00	$313.30	$541.79
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $149.81 / $223.23 / $424.56	Professional		$149.81	$223.23	$424.56
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.45 / $59.04 / $108.10	Professional	26	$42.45	$59.04	$108.10
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $96.39 / $173.51 / $329.32	Professional	TC	$96.39	$173.51	$329.32
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $184.49 / $184.49 / $305.00	Facility		$184.49	$184.49	$305.00
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $38.72 / $38.72 / $124.00	Facility	26	$38.72	$38.72	$124.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $181.43 / $184.49 / $305.00	Professional		$181.43	$184.49	$305.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $37.54 / $38.95 / $124.00	Professional	26	$37.54	$38.95	$124.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $142.47 / $145.75 / $181.00	Professional	TC	$142.47	$145.75	$181.00
United Facility/Professional Facility Modifier Low / Median / High Price $162.00 / $577.00 / $3,742.00	Facility		$162.00	$577.00	$3,742.00
United Facility/Professional Professional Modifier Low / Median / High Price $148.38 / $231.07 / $313.20	Professional		$148.38	$231.07	$313.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.11 / $53.03 / $86.94	Professional	26	$41.11	$53.03	$86.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $99.17 / $150.01 / $233.34	Professional	TC	$99.17	$150.01	$233.34