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 / $172.35	Facility	26	$61.24	$75.81	$172.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $146.28 / $198.87 / $781.73	Professional		$146.28	$198.87	$781.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.15 / $67.38 / $176.48	Professional	26	$55.15	$67.38	$176.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $86.11 / $119.70 / $280.51	Professional	TC	$86.11	$119.70	$280.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.87 / $79.87 / $144.88	Professional		$79.87	$79.87	$144.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.07 / $59.01 / $94.91	Professional	26	$46.07	$59.01	$94.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $148.44 / $154.06 / $343.29	Professional		$148.44	$154.06	$343.29
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $60.73 / $63.02 / $119.88	Professional	26	$60.73	$63.02	$119.88
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $87.73 / $91.04 / $223.42	Professional	TC	$87.73	$91.04	$223.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.44 / $69.44 / $69.44	Facility	26	$69.44	$69.44	$69.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.05 / $260.67 / $443.82	Professional		$140.05	$260.67	$443.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.12 / $73.54 / $121.07	Professional	26	$44.12	$73.54	$121.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $88.50 / $169.50 / $316.54	Professional	TC	$88.50	$169.50	$316.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $177.52 / $234.80 / $631.66	Professional		$177.52	$234.80	$631.66
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 $104.97 / $130.74 / $186.23	Professional	TC	$104.97	$130.74	$186.23
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $172.92 / $190.22 / $200.49	Professional		$172.92	$190.22	$200.49
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.52 / $75.55 / $105.34	Professional	26	$67.52	$75.55	$105.34
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $163.54 / $163.54 / $163.54	Professional	TC	$163.54	$163.54	$163.54
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $61.24 / $86.50 / $200.11	Facility	26	$61.24	$86.50	$200.11
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $146.29 / $211.47 / $647.36	Professional		$146.29	$211.47	$647.36
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $57.37 / $78.79 / $176.48	Professional	26	$57.37	$78.79	$176.48
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $87.96 / $124.96 / $324.67	Professional	TC	$87.96	$124.96	$324.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $62.51 / $143.38 / $325.00	Professional		$62.51	$143.38	$325.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $42.06 / $69.44 / $69.44	Facility	26	$42.06	$69.44	$69.44
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $144.10 / $249.01 / $425.90	Professional		$144.10	$249.01	$425.90
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.30 / $73.06 / $124.00	Professional	26	$46.30	$73.06	$124.00
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $88.50 / $164.50 / $304.77	Professional	TC	$88.50	$164.50	$304.77
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 $148.13 / $150.16 / $262.50	Professional		$148.13	$150.16	$262.50
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 $87.82 / $89.78 / $192.50	Professional	TC	$87.82	$89.78	$192.50
United Facility/Professional Professional Modifier Low / Median / High Price $143.59 / $207.40 / $328.72	Professional		$143.59	$207.40	$328.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.12 / $71.90 / $122.03	Professional	26	$56.12	$71.90	$122.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $85.53 / $121.69 / $223.98	Professional	TC	$85.53	$121.69	$223.98