Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.26 / $103.09 / $181.22	Facility	26	$83.26	$103.09	$181.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $236.84 / $328.19 / $1,077.40	Professional		$236.84	$328.19	$1,077.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.00 / $89.00 / $249.69	Professional	26	$74.00	$89.00	$249.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $159.21 / $227.00 / $604.57	Professional	TC	$159.21	$227.00	$604.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.05 / $133.11 / $208.79	Professional		$91.05	$133.11	$208.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.65 / $91.98 / $136.08	Professional	26	$63.65	$91.98	$136.08
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $136.16 / $136.16 / $162.63	Professional	TC	$136.16	$136.16	$162.63
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $91.02 / $106.30 / $773.92	Professional	26	$91.02	$106.30	$773.92
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $257.70 / $267.42 / $536.30	Professional		$257.70	$267.42	$536.30
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $82.56 / $104.51 / $163.19	Professional	26	$82.56	$104.51	$163.19
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $175.13 / $181.74 / $368.22	Professional	TC	$175.13	$181.74	$368.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.56 / $94.56 / $94.56	Facility	26	$94.56	$94.56	$94.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $256.30 / $514.85 / $936.76	Professional		$256.30	$514.85	$936.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.96 / $101.26 / $166.20	Professional	26	$59.96	$101.26	$166.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $178.41 / $362.27 / $797.88	Professional	TC	$178.41	$362.27	$797.88
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $310.54 / $411.95 / $1,439.36	Professional		$310.54	$411.95	$1,439.36
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $90.35 / $108.48 / $171.25	Professional	26	$90.35	$108.48	$171.25
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $209.61 / $260.94 / $371.65	Professional	TC	$209.61	$260.94	$371.65
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $318.08 / $330.76 / $351.39	Professional		$318.08	$330.76	$351.39
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.90 / $99.95 / $144.57	Professional	26	$91.90	$99.95	$144.57
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $352.56 / $352.56 / $352.86	Professional	TC	$352.56	$352.56	$352.86
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $86.78 / $106.30 / $199.87	Professional	26	$86.78	$106.30	$199.87
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $79.30 / $114.98 / $271.83	Facility	26	$79.30	$114.98	$271.83
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $241.94 / $345.22 / $1,017.70	Professional		$241.94	$345.22	$1,017.70
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $74.65 / $96.32 / $236.81	Professional	26	$74.65	$96.32	$236.81
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $162.63 / $234.61 / $675.03	Professional	TC	$162.63	$234.61	$675.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $99.79 / $266.81 / $512.60	Professional		$99.79	$266.81	$512.60
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $57.34 / $94.56 / $94.56	Facility	26	$57.34	$94.56	$94.56
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $256.30 / $500.71 / $928.35	Professional		$256.30	$500.71	$928.35
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $62.46 / $100.77 / $169.00	Professional	26	$62.46	$100.77	$169.00
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $178.41 / $362.27 / $767.15	Professional	TC	$178.41	$362.27	$767.15
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $82.29 / $82.29 / $91.08	Facility	26	$82.29	$82.29	$91.08
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $246.94 / $251.46 / $470.00	Professional		$246.94	$251.46	$470.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $80.14 / $82.38 / $91.08	Professional	26	$80.14	$82.38	$91.08
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $164.57 / $171.32 / $378.92	Professional	TC	$164.57	$171.32	$378.92
United Facility/Professional Professional Modifier Low / Median / High Price $257.49 / $377.59 / $662.68	Professional		$257.49	$377.59	$662.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.08 / $96.71 / $173.27	Professional	26	$76.08	$96.71	$173.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $178.41 / $267.16 / $517.84	Professional	TC	$178.41	$267.16	$517.84