Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.20 / $76.01 / $175.61	Facility	26	$55.20	$76.01	$175.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.13 / $175.36 / $429.12	Professional		$141.13	$175.36	$429.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.85 / $56.66 / $155.43	Professional	26	$47.85	$56.66	$155.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $90.95 / $118.26 / $240.00	Professional	TC	$90.95	$118.26	$240.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.33 / $56.33 / $98.57	Professional		$56.33	$56.33	$98.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.11 / $77.29 / $100.68	Professional	26	$41.11	$77.29	$100.68
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $146.49 / $241.80 / $459.21	Professional		$146.49	$241.80	$459.21
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $53.36 / $86.98 / $131.30	Professional	26	$53.36	$86.98	$131.30
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $93.13 / $154.82 / $359.29	Professional	TC	$93.13	$154.82	$359.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.34 / $61.34 / $61.34	Facility	26	$61.34	$61.34	$61.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.11 / $260.14 / $458.93	Professional		$129.11	$260.14	$458.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.79 / $65.34 / $106.14	Professional	26	$38.79	$65.34	$106.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $82.48 / $172.95 / $330.21	Professional	TC	$82.48	$172.95	$330.21
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $175.87 / $233.05 / $665.41	Professional		$175.87	$233.05	$665.41
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.39 / $70.13 / $110.70	Professional	26	$58.39	$70.13	$110.70
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $111.49 / $138.74 / $197.56	Professional	TC	$111.49	$138.74	$197.56
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $293.54 / $293.54 / $297.20	Professional		$293.54	$293.54	$297.20
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.64 / $65.61 / $101.11	Professional	26	$59.64	$65.61	$101.11
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $55.20 / $77.45 / $186.85	Facility	26	$55.20	$77.45	$186.85
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $144.16 / $205.78 / $520.80	Professional		$144.16	$205.78	$520.80
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $48.58 / $69.08 / $155.13	Professional	26	$48.58	$69.08	$155.13
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $92.90 / $124.76 / $346.50	Professional	TC	$92.90	$124.76	$346.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $57.11 / $147.82 / $325.00	Professional		$57.11	$147.82	$325.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $37.02 / $61.34 / $61.34	Facility	26	$37.02	$61.34	$61.34
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $138.19 / $244.77 / $443.11	Professional		$138.19	$244.77	$443.11
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.28 / $65.16 / $109.03	Professional	26	$40.28	$65.16	$109.03
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $87.86 / $161.97 / $322.70	Professional	TC	$87.86	$161.97	$322.70
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $53.10 / $53.10 / $60.50	Facility	26	$53.10	$53.10	$60.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $145.58 / $147.62 / $277.50	Professional		$145.58	$147.62	$277.50
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $51.73 / $53.12 / $60.50	Professional	26	$51.73	$53.12	$60.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $92.46 / $94.52 / $217.00	Professional	TC	$92.46	$94.52	$217.00
United Facility/Professional Professional Modifier Low / Median / High Price $142.05 / $209.30 / $358.18	Professional		$142.05	$209.30	$358.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.35 / $61.68 / $104.65	Professional	26	$49.35	$61.68	$104.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.72 / $128.21 / $245.80	Professional	TC	$91.72	$128.21	$245.80