Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.57 / $73.29 / $193.81	Facility	26	$60.57	$73.29	$193.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $202.10 / $254.22 / $771.54	Professional		$202.10	$254.22	$771.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.50 / $63.79 / $154.51	Professional	26	$53.50	$63.79	$154.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $145.63 / $186.15 / $398.36	Professional	TC	$145.63	$186.15	$398.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $142.65 / $142.65 / $235.68	Professional		$142.65	$142.65	$235.68
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.09 / $46.09 / $54.97	Professional	26	$46.09	$46.09	$54.97
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $206.28 / $273.51 / $576.84	Professional		$206.28	$273.51	$576.84
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $59.75 / $97.31 / $168.64	Professional	26	$59.75	$97.31	$168.64
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $146.52 / $195.48 / $448.54	Professional	TC	$146.52	$195.48	$448.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.70 / $68.70 / $68.70	Facility	26	$68.70	$68.70	$68.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.33 / $385.05 / $657.31	Professional		$204.33	$385.05	$657.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.43 / $78.68 / $133.50	Professional	26	$46.43	$78.68	$133.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.29 / $290.51 / $527.76	Professional	TC	$151.29	$290.51	$527.76
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $249.22 / $330.82 / $979.41	Professional		$249.22	$330.82	$979.41
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $65.37 / $78.45 / $123.88	Professional	26	$65.37	$78.45	$123.88
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $175.35 / $218.34 / $311.01	Professional	TC	$175.35	$218.34	$311.01
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $267.79 / $267.79 / $267.79	Professional		$267.79	$267.79	$267.79
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.77 / $67.61 / $89.65	Professional	26	$66.77	$67.61	$89.65
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $60.57 / $83.65 / $213.22	Facility	26	$60.57	$83.65	$213.22
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $206.45 / $275.00 / $957.00	Professional		$206.45	$275.00	$957.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $57.68 / $71.50 / $175.61	Professional	26	$57.68	$71.50	$175.61
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $148.76 / $193.52 / $548.26	Professional	TC	$148.76	$193.52	$548.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $84.56 / $243.30 / $390.84	Professional		$84.56	$243.30	$390.84
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $47.51 / $68.70 / $68.70	Facility	26	$47.51	$68.70	$68.70
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $209.34 / $376.28 / $657.31	Professional		$209.34	$376.28	$657.31
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.51 / $79.61 / $133.50	Professional	26	$46.51	$79.61	$133.50
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $152.05 / $282.50 / $525.95	Professional	TC	$152.05	$282.50	$525.95
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $59.41 / $59.41 / $82.50	Facility	26	$59.41	$59.41	$82.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $206.99 / $210.21 / $415.00	Professional		$206.99	$210.21	$415.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $57.87 / $59.47 / $82.50	Professional	26	$57.87	$59.47	$82.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $147.52 / $150.79 / $332.50	Professional	TC	$147.52	$150.79	$332.50
United Facility/Professional Professional Modifier Low / Median / High Price $214.06 / $304.79 / $498.02	Professional		$214.06	$304.79	$498.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.37 / $71.09 / $118.86	Professional	26	$56.37	$71.09	$118.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $157.66 / $227.73 / $411.24	Professional	TC	$157.66	$227.73	$411.24