Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.53 / $101.25 / $241.92	Facility	26	$60.53	$101.25	$241.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $221.72 / $425.00 / $630.00	Professional		$221.72	$425.00	$630.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.65 / $125.48 / $298.80	Professional	26	$57.65	$125.48	$298.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.90 / $299.00 / $422.10	Professional	TC	$162.90	$299.00	$422.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $146.27 / $156.97 / $163.65	Professional		$146.27	$156.97	$163.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.41 / $60.77 / $99.96	Professional	26	$43.41	$60.77	$99.96
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $241.19 / $241.19 / $241.19	Professional	TC	$241.19	$241.19	$241.19
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $65.45 / $76.34 / $548.66	Professional	26	$65.45	$76.34	$548.66
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $211.50 / $365.11 / $817.15	Professional		$211.50	$365.11	$817.15
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $56.40 / $92.42 / $139.79	Professional	26	$56.40	$92.42	$139.79
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $155.11 / $269.06 / $710.76	Professional	TC	$155.11	$269.06	$710.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.84 / $64.84 / $64.84	Facility	26	$64.84	$64.84	$64.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $214.52 / $462.47 / $857.75	Professional		$214.52	$462.47	$857.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.42 / $69.59 / $115.85	Professional	26	$41.42	$69.59	$115.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $160.96 / $355.56 / $765.49	Professional	TC	$160.96	$355.56	$765.49
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $256.06 / $340.17 / $1,357.17	Professional		$256.06	$340.17	$1,357.17
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.67 / $74.09 / $117.04	Professional	26	$61.67	$74.09	$117.04
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $185.67 / $231.09 / $329.10	Professional	TC	$185.67	$231.09	$329.10
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $249.17 / $274.08 / $650.15	Professional		$249.17	$274.08	$650.15
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.02 / $69.33 / $99.55	Professional	26	$63.02	$69.33	$99.55
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $242.35 / $290.00 / $290.82	Professional	TC	$242.35	$290.00	$290.82
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $65.45 / $76.34 / $548.66	Professional	26	$65.45	$76.34	$548.66
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $60.53 / $85.19 / $374.22	Facility	26	$60.53	$85.19	$374.22
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $221.72 / $425.00 / $1,192.00	Professional		$221.72	$425.00	$1,192.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $57.65 / $118.10 / $283.00	Professional	26	$57.65	$118.10	$283.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $164.07 / $299.00 / $663.78	Professional	TC	$164.07	$299.00	$663.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $79.81 / $260.16 / $607.50	Professional		$79.81	$260.16	$607.50
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $39.39 / $64.84 / $64.84	Facility	26	$39.39	$64.84	$64.84
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $219.48 / $453.90 / $850.66	Professional		$219.48	$453.90	$850.66
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.64 / $69.01 / $116.05	Professional	26	$43.64	$69.01	$116.05
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $160.96 / $355.56 / $763.68	Professional	TC	$160.96	$355.56	$763.68
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $56.42 / $56.42 / $64.50	Facility	26	$56.42	$56.42	$64.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $211.67 / $215.12 / $486.00	Professional		$211.67	$215.12	$486.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $54.99 / $56.42 / $64.50	Professional	26	$54.99	$56.42	$64.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $155.25 / $158.69 / $421.50	Professional	TC	$155.25	$158.69	$421.50
United Facility/Professional Professional Modifier Low / Median / High Price $205.42 / $335.00 / $602.24	Professional		$205.42	$335.00	$602.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.96 / $66.76 / $111.51	Professional	26	$48.96	$66.76	$111.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $152.99 / $237.40 / $499.64	Professional	TC	$152.99	$237.40	$499.64