Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.09 / $126.00 / $249.47	Facility	26	$74.09	$126.00	$249.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $273.70 / $425.00 / $1,719.73	Professional		$273.70	$425.00	$1,719.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.56 / $126.00 / $193.26	Professional	26	$70.56	$126.00	$193.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $199.21 / $299.00 / $370.63	Professional	TC	$199.21	$299.00	$370.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $177.78 / $177.78 / $181.92	Professional		$177.78	$177.78	$181.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.43 / $98.34 / $98.34	Professional	26	$52.43	$98.34	$98.34
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $257.02 / $266.72 / $567.05	Professional		$257.02	$266.72	$567.05
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $69.48 / $72.12 / $137.65	Professional	26	$69.48	$72.12	$137.65
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $187.52 / $194.60 / $442.36	Professional	TC	$187.52	$194.60	$442.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.91 / $79.91 / $79.91	Facility	26	$79.91	$79.91	$79.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $240.61 / $478.17 / $831.63	Professional		$240.61	$478.17	$831.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.67 / $85.71 / $138.72	Professional	26	$50.67	$85.71	$138.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $176.91 / $348.85 / $646.59	Professional	TC	$176.91	$348.85	$646.59
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $311.06 / $413.24 / $1,217.35	Professional		$311.06	$413.24	$1,217.35
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $76.02 / $91.24 / $144.08	Professional	26	$76.02	$91.24	$144.08
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $224.43 / $279.41 / $397.98	Professional	TC	$224.43	$279.41	$397.98
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $289.00 / $305.70 / $523.40	Professional		$289.00	$305.70	$523.40
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.65 / $83.48 / $134.62	Professional	26	$77.65	$83.48	$134.62
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $355.78 / $355.78 / $355.78	Professional	TC	$355.78	$355.78	$355.78
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $74.09 / $126.00 / $398.16	Facility	26	$74.09	$126.00	$398.16
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $276.56 / $425.00 / $1,695.00	Professional		$276.56	$425.00	$1,695.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $70.56 / $126.00 / $269.64	Professional	26	$70.56	$126.00	$269.64
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $205.98 / $299.00 / $729.56	Professional	TC	$205.98	$299.00	$729.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $687.50 / $700.00 / $785.70	Professional		$687.50	$700.00	$785.70
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $48.77 / $79.91 / $79.91	Facility	26	$48.77	$79.91	$79.91
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $253.40 / $456.20 / $809.33	Professional		$253.40	$456.20	$809.33
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.16 / $85.23 / $141.00	Professional	26	$53.16	$85.23	$141.00
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $186.90 / $331.43 / $638.60	Professional	TC	$186.90	$331.43	$638.60
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $69.05 / $69.05 / $78.50	Facility	26	$69.05	$69.05	$78.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $261.75 / $266.00 / $504.50	Professional		$261.75	$266.00	$504.50
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $67.26 / $69.11 / $78.50	Professional	26	$67.26	$69.11	$78.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $192.64 / $196.95 / $426.00	Professional	TC	$192.64	$196.95	$426.00
United Facility/Professional Professional Modifier Low / Median / High Price $267.27 / $395.73 / $618.53	Professional		$267.27	$395.73	$618.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.27 / $79.34 / $140.71	Professional	26	$63.27	$79.34	$140.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $200.27 / $283.06 / $505.26	Professional	TC	$200.27	$283.06	$505.26