Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.15 / $96.33 / $193.81	Facility	26	$77.15	$96.33	$193.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $212.13 / $292.85 / $1,057.67	Professional		$212.13	$292.85	$1,057.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.17 / $78.59 / $188.57	Professional	26	$62.17	$78.59	$188.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $140.19 / $185.56 / $402.89	Professional	TC	$140.19	$185.56	$402.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $146.30 / $166.61 / $177.40	Professional		$146.30	$166.61	$177.40
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.72 / $59.08 / $82.09	Professional	26	$57.72	$59.08	$82.09
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $217.64 / $363.21 / $576.26	Professional		$217.64	$363.21	$576.26
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $76.20 / $115.95 / $167.82	Professional	26	$76.20	$115.95	$167.82
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $141.44 / $239.23 / $448.54	Professional	TC	$141.44	$239.23	$448.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.25 / $87.25 / $87.25	Facility	26	$87.25	$87.25	$87.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $205.32 / $373.58 / $624.15	Professional		$205.32	$373.58	$624.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.36 / $86.88 / $144.57	Professional	26	$54.36	$86.88	$144.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $142.15 / $266.85 / $477.65	Professional	TC	$142.15	$266.85	$477.65
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $261.51 / $346.41 / $917.67	Professional		$261.51	$346.41	$917.67
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.33 / $100.10 / $158.09	Professional	26	$83.33	$100.10	$158.09
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $169.27 / $210.76 / $300.20	Professional	TC	$169.27	$210.76	$300.20
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $255.07 / $255.07 / $280.58	Professional		$255.07	$255.07	$280.58
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $84.62 / $88.16 / $114.62	Professional	26	$84.62	$88.16	$114.62
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $77.15 / $108.55 / $268.16	Facility	26	$77.15	$108.55	$268.16
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $216.69 / $300.82 / $957.00	Professional		$216.69	$300.82	$957.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $69.00 / $89.86 / $183.36	Professional	26	$69.00	$89.86	$183.36
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $143.21 / $189.47 / $526.09	Professional	TC	$143.21	$189.47	$526.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $87.11 / $207.42 / $412.34	Professional		$87.11	$207.42	$412.34
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $47.26 / $87.25 / $87.25	Facility	26	$47.26	$87.25	$87.25
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $208.39 / $362.67 / $611.66	Professional		$208.39	$362.67	$611.66
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $55.54 / $86.88 / $145.80	Professional	26	$55.54	$86.88	$145.80
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $142.15 / $258.16 / $475.36	Professional	TC	$142.15	$258.16	$475.36
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $75.69 / $75.69 / $80.00	Facility	26	$75.69	$75.69	$80.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $218.59 / $221.74 / $381.00	Professional		$218.59	$221.74	$381.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $73.78 / $75.70 / $80.00	Professional	26	$73.78	$75.70	$80.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $142.88 / $146.05 / $301.00	Professional	TC	$142.88	$146.05	$301.00
United Facility/Professional Professional Modifier Low / Median / High Price $213.08 / $298.41 / $481.50	Professional		$213.08	$298.41	$481.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.06 / $90.06 / $146.90	Professional	26	$67.06	$90.06	$146.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $139.40 / $196.27 / $365.03	Professional	TC	$139.40	$196.27	$365.03