Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.24 / $75.81 / $133.41	Facility	26	$61.24	$75.81	$133.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.32 / $232.78 / $782.54	Professional		$154.32	$232.78	$782.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.15 / $78.56 / $189.26	Professional	26	$55.15	$78.56	$189.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.69 / $132.30 / $312.45	Professional	TC	$95.69	$132.30	$312.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $108.73 / $120.81 / $139.38	Professional		$108.73	$120.81	$139.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.83 / $63.02 / $100.14	Professional	26	$46.83	$63.02	$100.14
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $149.76 / $149.76 / $149.76	Professional	TC	$149.76	$149.76	$149.76
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $157.04 / $162.97 / $162.97	Professional		$157.04	$162.97	$162.97
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $60.73 / $98.90 / $148.91	Professional	26	$60.73	$98.90	$148.91
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $96.30 / $127.83 / $394.00	Professional	TC	$96.30	$127.83	$394.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.79 / $69.79 / $69.79	Facility	26	$69.79	$69.79	$69.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $155.55 / $287.38 / $509.56	Professional		$155.55	$287.38	$509.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.12 / $73.80 / $120.82	Professional	26	$44.12	$73.80	$120.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $99.94 / $195.53 / $381.33	Professional	TC	$99.94	$195.53	$381.33
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $188.20 / $249.30 / $720.22	Professional		$188.20	$249.30	$720.22
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.50 / $79.84 / $125.95	Professional	26	$66.50	$79.84	$125.95
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $115.29 / $143.47 / $204.31	Professional	TC	$115.29	$143.47	$204.31
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $183.42 / $201.77 / $320.00	Professional		$183.42	$201.77	$320.00
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.89 / $74.98 / $99.73	Professional	26	$67.89	$74.98	$99.73
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $179.54 / $180.23 / $180.23	Professional	TC	$179.54	$180.23	$180.23
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $58.32 / $84.57 / $200.11	Facility	26	$58.32	$84.57	$200.11
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $154.32 / $232.78 / $697.19	Professional		$154.32	$232.78	$697.19
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $57.28 / $81.90 / $176.88	Professional	26	$57.28	$81.90	$176.88
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $95.99 / $135.28 / $356.69	Professional	TC	$95.99	$135.28	$356.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $85.94 / $163.07 / $328.62	Professional		$85.94	$163.07	$328.62
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $42.06 / $69.79 / $69.79	Facility	26	$42.06	$69.79	$69.79
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $162.96 / $276.41 / $509.56	Professional		$162.96	$276.41	$509.56
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.30 / $73.06 / $123.35	Professional	26	$46.30	$73.06	$123.35
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $99.94 / $194.72 / $381.16	Professional	TC	$99.94	$194.72	$381.16
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $60.38 / $60.38 / $70.00	Facility	26	$60.38	$60.38	$70.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $156.28 / $158.38 / $312.00	Professional		$156.28	$158.38	$312.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $58.83 / $60.42 / $70.00	Professional	26	$58.83	$60.42	$70.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $95.86 / $98.00 / $242.00	Professional	TC	$95.86	$98.00	$242.00
United Facility/Professional Professional Modifier Low / Median / High Price $173.02 / $228.40 / $403.42	Professional		$173.02	$228.40	$403.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.83 / $70.59 / $118.40	Professional	26	$55.83	$70.59	$118.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $116.57 / $166.27 / $305.24	Professional	TC	$116.57	$166.27	$305.24