Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.12 / $126.00 / $403.20	Facility	26	$79.12	$126.00	$403.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $233.74 / $415.80 / $522.50	Professional		$233.74	$415.80	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.33 / $119.21 / $154.00	Professional	26	$57.33	$119.21	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $174.69 / $299.00 / $368.50	Professional	TC	$174.69	$299.00	$368.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $171.15 / $171.15 / $181.27	Professional		$171.15	$171.15	$181.27
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.94 / $86.61 / $86.61	Professional	26	$41.94	$86.61	$86.61
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $223.27 / $231.69 / $681.09	Professional		$223.27	$231.69	$681.09
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $56.40 / $58.53 / $112.05	Professional	26	$56.40	$58.53	$112.05
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $166.87 / $173.16 / $569.07	Professional	TC	$166.87	$173.16	$569.07
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 $221.16 / $465.48 / $854.15	Professional		$221.16	$465.48	$854.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.15 / $69.17 / $115.85	Professional	26	$41.15	$69.17	$115.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $172.42 / $355.39 / $761.89	Professional	TC	$172.42	$355.39	$761.89
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $270.62 / $359.61 / $1,351.82	Professional		$270.62	$359.61	$1,351.82
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 $199.73 / $248.61 / $354.09	Professional	TC	$199.73	$248.61	$354.09
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $59.09 / $68.23 / $96.49	Professional	26	$59.09	$68.23	$96.49
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $79.12 / $160.81 / $412.02	Facility	26	$79.12	$160.81	$412.02
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $233.74 / $425.00 / $1,320.50	Professional		$233.74	$425.00	$1,320.50
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $57.33 / $120.54 / $322.00	Professional	26	$57.33	$120.54	$322.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $176.41 / $299.00 / $729.56	Professional	TC	$176.41	$299.00	$729.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $79.81 / $279.76 / $607.50	Professional		$79.81	$279.76	$607.50
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $39.14 / $64.84 / $64.84	Facility	26	$39.14	$64.84	$64.84
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $227.63 / $454.94 / $848.98	Professional		$227.63	$454.94	$848.98
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.37 / $69.01 / $116.05	Professional	26	$43.37	$69.01	$116.05
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $171.12 / $354.52 / $760.14	Professional	TC	$171.12	$354.52	$760.14
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $56.10 / $56.10 / $64.50	Facility	26	$56.10	$56.10	$64.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $223.52 / $227.11 / $486.00	Professional		$223.52	$227.11	$486.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $54.68 / $56.12 / $64.50	Professional	26	$54.68	$56.12	$64.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $167.40 / $171.01 / $421.50	Professional	TC	$167.40	$171.01	$421.50
United Facility/Professional Professional Modifier Low / Median / High Price $221.95 / $332.15 / $573.77	Professional		$221.95	$332.15	$573.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.22 / $67.09 / $111.52	Professional	26	$48.22	$67.09	$111.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $167.71 / $250.64 / $503.53	Professional	TC	$167.71	$250.64	$503.53