Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.57 / $82.50 / $210.55	Facility	26	$60.57	$82.50	$210.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $176.73 / $225.20 / $634.57	Professional		$176.73	$225.20	$634.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.00 / $64.70 / $153.72	Professional	26	$55.00	$64.70	$153.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.26 / $153.68 / $375.94	Professional	TC	$120.26	$153.68	$375.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $111.42 / $112.30 / $128.00	Professional		$111.42	$112.30	$128.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.32 / $50.08 / $91.75	Professional	26	$45.32	$50.08	$91.75
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $181.16 / $188.00 / $239.46	Professional		$181.16	$188.00	$239.46
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $59.75 / $97.84 / $164.42	Professional	26	$59.75	$97.84	$164.42
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $121.41 / $204.54 / $448.54	Professional	TC	$121.41	$204.54	$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 $170.91 / $347.38 / $602.92	Professional		$170.91	$347.38	$602.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.55 / $77.13 / $123.25	Professional	26	$45.55	$77.13	$123.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $114.54 / $238.50 / $487.46	Professional	TC	$114.54	$238.50	$487.46
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $218.13 / $289.30 / $931.42	Professional		$218.13	$289.30	$931.42
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 $145.32 / $180.91 / $257.66	Professional	TC	$145.32	$180.91	$257.66
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.77 / $71.72 / $91.26	Professional	26	$66.77	$71.72	$91.26
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $60.57 / $107.20 / $213.22	Facility	26	$60.57	$107.20	$213.22
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $180.54 / $258.07 / $733.39	Professional		$180.54	$258.07	$733.39
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $56.47 / $71.18 / $179.24	Professional	26	$56.47	$71.18	$179.24
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $122.85 / $172.95 / $548.83	Professional	TC	$122.85	$172.95	$548.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $189.47 / $337.22	Professional		$68.20	$189.47	$337.22
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $46.31 / $68.70 / $68.70	Facility	26	$46.31	$68.70	$68.70
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $179.46 / $335.97 / $597.91	Professional		$179.46	$335.97	$597.91
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.24 / $78.31 / $123.25	Professional	26	$46.24	$78.31	$123.25
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $120.27 / $226.42 / $474.11	Professional	TC	$120.27	$226.42	$474.11
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $59.73 / $59.73 / $84.00	Facility	26	$59.73	$59.73	$84.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $181.95 / $184.60 / $423.00	Professional		$181.95	$184.60	$423.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $58.18 / $59.77 / $84.00	Professional	26	$58.18	$59.77	$84.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $122.18 / $124.87 / $339.00	Professional	TC	$122.18	$124.87	$339.00
United Facility/Professional Professional Modifier Low / Median / High Price $177.04 / $258.63 / $465.90	Professional		$177.04	$258.63	$465.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.43 / $71.09 / $119.50	Professional	26	$57.43	$71.09	$119.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $119.61 / $172.77 / $344.49	Professional	TC	$119.61	$172.77	$344.49