Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.90 / $75.40 / $132.66	Facility	26	$60.90	$75.40	$132.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.86 / $212.39 / $520.79	Professional		$165.86	$212.39	$520.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.83 / $67.01 / $174.56	Professional	26	$53.83	$67.01	$174.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.08 / $145.47 / $313.58	Professional	TC	$109.08	$145.47	$313.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $118.35 / $131.50 / $131.50	Professional		$118.35	$131.50	$131.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.53 / $52.74 / $87.03	Professional	26	$45.53	$52.74	$87.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $103.01 / $103.01 / $103.01	Professional	TC	$103.01	$103.01	$103.01
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $290.50 / $736.81	Professional		$171.00	$290.50	$736.81
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $60.07 / $97.84 / $148.91	Professional	26	$60.07	$97.84	$148.91
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $110.93 / $189.67 / $587.90	Professional	TC	$110.93	$189.67	$587.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.05 / $69.05 / $69.05	Facility	26	$69.05	$69.05	$69.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.07 / $311.74 / $552.60	Professional		$151.07	$311.74	$552.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.88 / $73.69 / $120.42	Professional	26	$43.88	$73.69	$120.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $98.59 / $210.00 / $408.61	Professional	TC	$98.59	$210.00	$408.61
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $205.54 / $272.48 / $808.46	Professional		$205.54	$272.48	$808.46
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $65.76 / $78.94 / $124.56	Professional	26	$65.76	$78.94	$124.56
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $132.77 / $165.28 / $235.38	Professional	TC	$132.77	$165.28	$235.38
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $189.35 / $220.33 / $220.33	Professional		$189.35	$220.33	$220.33
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.14 / $71.94 / $98.63	Professional	26	$67.14	$71.94	$98.63
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $207.73 / $207.73 / $207.73	Professional	TC	$207.73	$207.73	$207.73
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $60.90 / $84.10 / $199.01	Facility	26	$60.90	$84.10	$199.01
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $169.42 / $228.88 / $557.41	Professional		$169.42	$228.88	$557.41
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $56.78 / $78.15 / $171.37	Professional	26	$56.78	$78.15	$171.37
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $111.43 / $148.60 / $342.47	Professional	TC	$111.43	$148.60	$342.47
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $68.02 / $176.05 / $325.00	Professional		$68.02	$176.05	$325.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $41.83 / $69.05 / $69.05	Facility	26	$41.83	$69.05	$69.05
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $161.32 / $300.00 / $529.30	Professional		$161.32	$300.00	$529.30
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.07 / $73.12 / $122.65	Professional	26	$46.07	$73.12	$122.65
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $104.65 / $200.32 / $397.78	Professional	TC	$104.65	$200.32	$397.78
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $59.73 / $59.73 / $68.00	Facility	26	$59.73	$59.73	$68.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $171.03 / $173.53 / $339.00	Professional		$171.03	$173.53	$339.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $58.18 / $59.77 / $68.00	Professional	26	$58.18	$59.77	$68.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $111.36 / $113.80 / $271.00	Professional	TC	$111.36	$113.80	$271.00
United Facility/Professional Professional Modifier Low / Median / High Price $166.39 / $240.34 / $386.54	Professional		$166.39	$240.34	$386.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.22 / $70.78 / $117.73	Professional	26	$55.22	$70.78	$117.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $108.96 / $150.13 / $290.22	Professional	TC	$108.96	$150.13	$290.22