Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.50 / $67.45 / $174.45	Facility	26	$53.50	$67.45	$174.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.87 / $204.38 / $519.15	Professional		$147.87	$204.38	$519.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.96 / $69.08 / $193.00	Professional	26	$50.96	$69.08	$193.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.31 / $125.29 / $301.27	Professional	TC	$96.31	$125.29	$301.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $73.33 / $80.73 / $92.27	Professional		$73.33	$80.73	$92.27
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.11 / $55.11 / $87.95	Professional	26	$41.11	$55.11	$87.95
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $149.99 / $248.54 / $474.62	Professional		$149.99	$248.54	$474.62
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $53.36 / $86.98 / $151.61	Professional	26	$53.36	$86.98	$151.61
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $96.62 / $161.57 / $359.29	Professional	TC	$96.62	$161.57	$359.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.98 / $60.98 / $60.98	Facility	26	$60.98	$60.98	$60.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.50 / $287.64 / $500.31	Professional		$141.50	$287.64	$500.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.36 / $69.73 / $113.96	Professional	26	$40.36	$69.73	$113.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $91.15 / $188.39 / $390.06	Professional	TC	$91.15	$188.39	$390.06
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $180.20 / $238.83 / $762.13	Professional		$180.20	$238.83	$762.13
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 $115.67 / $143.94 / $205.00	Professional	TC	$115.67	$143.94	$205.00
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $175.55 / $193.11 / $193.45	Professional		$175.55	$193.11	$193.45
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.27 / $75.11 / $103.39	Professional	26	$59.27	$75.11	$103.39
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $53.50 / $76.01 / $175.54	Facility	26	$53.50	$76.01	$175.54
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $147.87 / $213.66 / $612.39	Professional		$147.87	$213.66	$612.39
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $50.96 / $78.42 / $175.21	Professional	26	$50.96	$78.42	$175.21
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $96.92 / $132.16 / $431.50	Professional	TC	$96.92	$132.16	$431.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $59.40 / $153.51 / $325.00	Professional		$59.40	$153.51	$325.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $42.78 / $60.98 / $60.98	Facility	26	$42.78	$60.98	$60.98
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $141.50 / $283.77 / $491.99	Professional		$141.50	$283.77	$491.99
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.53 / $70.76 / $113.96	Professional	26	$41.53	$70.76	$113.96
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $91.15 / $180.97 / $380.10	Professional	TC	$91.15	$180.97	$380.10
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $53.10 / $53.10 / $71.00	Facility	26	$53.10	$53.10	$71.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $149.60 / $151.72 / $347.50	Professional		$149.60	$151.72	$347.50
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $51.73 / $53.12 / $71.00	Professional	26	$51.73	$53.12	$71.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $96.48 / $98.64 / $276.50	Professional	TC	$96.48	$98.64	$276.50
United Facility/Professional Professional Modifier Low / Median / High Price $145.40 / $211.94 / $379.68	Professional		$145.40	$211.94	$379.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.05 / $65.23 / $106.22	Professional	26	$51.05	$65.23	$106.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $94.35 / $136.19 / $265.70	Professional	TC	$94.35	$136.19	$265.70