Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $92.17 / $126.00 / $249.47	Facility	26	$92.17	$126.00	$249.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.59 / $425.00 / $661.50	Professional		$338.59	$425.00	$661.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.90 / $126.00 / $322.00	Professional	26	$70.90	$126.00	$322.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $264.47 / $299.00 / $462.42	Professional	TC	$264.47	$299.00	$462.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.71 / $223.21 / $247.59	Professional		$158.71	$223.21	$247.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.95 / $78.67 / $107.20	Professional	26	$52.95	$78.67	$107.20
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $322.81 / $334.99 / $1,064.53	Professional		$322.81	$334.99	$1,064.53
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $69.81 / $72.45 / $168.40	Professional	26	$69.81	$72.45	$168.40
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $253.00 / $336.17 / $911.46	Professional	TC	$253.00	$336.17	$911.46
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.26 / $80.26 / $80.26	Facility	26	$80.26	$80.26	$80.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $320.45 / $709.81 / $1,491.88	Professional		$320.45	$709.81	$1,491.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.01 / $96.27 / $162.66	Professional	26	$55.01	$96.27	$162.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $261.32 / $597.30 / $1,275.49	Professional	TC	$261.32	$597.30	$1,275.49
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $392.58 / $522.35 / $2,277.80	Professional		$392.58	$522.35	$2,277.80
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $76.41 / $91.71 / $144.76	Professional	26	$76.41	$91.71	$144.76
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $302.80 / $376.98 / $536.95	Professional	TC	$302.80	$376.98	$536.95
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $360.98 / $977.72 / $1,016.99	Professional		$360.98	$977.72	$1,016.99
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $78.02 / $86.92 / $130.94	Professional	26	$78.02	$86.92	$130.94
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $394.98 / $394.98 / $394.98	Professional	TC	$394.98	$394.98	$394.98
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $70.90 / $126.00 / $398.16	Facility	26	$70.90	$126.00	$398.16
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $338.59 / $459.85 / $1,262.25	Professional		$338.59	$459.85	$1,262.25
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $70.90 / $126.00 / $322.00	Professional	26	$70.90	$126.00	$322.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $267.69 / $335.00 / $783.89	Professional	TC	$267.69	$335.00	$783.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $98.79 / $402.62 / $1,158.90	Professional		$98.79	$402.62	$1,158.90
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $59.00 / $80.26 / $80.26	Facility	26	$59.00	$80.26	$80.26
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $334.99 / $707.04 / $1,411.57	Professional		$334.99	$707.04	$1,411.57
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.02 / $96.80 / $162.66	Professional	26	$58.02	$96.80	$162.66
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $259.33 / $597.30 / $1,212.47	Professional	TC	$259.33	$597.30	$1,212.47
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $69.37 / $69.37 / $95.50	Facility	26	$69.37	$69.37	$95.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $323.04 / $328.59 / $924.50	Professional		$323.04	$328.59	$924.50
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $67.56 / $69.41 / $95.50	Professional	26	$67.56	$69.41	$95.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $253.63 / $259.22 / $829.00	Professional	TC	$253.63	$259.22	$829.00
United Facility/Professional Professional Modifier Low / Median / High Price $321.45 / $490.75 / $1,015.90	Professional		$321.45	$490.75	$1,015.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.73 / $86.00 / $140.04	Professional	26	$64.73	$86.00	$140.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $254.15 / $367.11 / $944.77	Professional	TC	$254.15	$367.11	$944.77