Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.56 / $126.00 / $249.47	Facility	26	$79.56	$126.00	$249.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $222.36 / $425.00 / $1,320.50	Professional		$222.36	$425.00	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.32 / $126.00 / $286.00	Professional	26	$57.32	$126.00	$286.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $163.22 / $299.00 / $368.50	Professional	TC	$163.22	$299.00	$368.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $130.41 / $130.41 / $150.13	Professional		$130.41	$130.41	$150.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.02 / $45.98 / $82.13	Professional	26	$43.02	$45.98	$82.13
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $212.14 / $352.87 / $816.51	Professional		$212.14	$352.87	$816.51
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $56.72 / $92.42 / $139.00	Professional	26	$56.72	$92.42	$139.00
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $155.43 / $260.45 / $710.76	Professional	TC	$155.43	$260.45	$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 $215.68 / $464.11 / $855.69	Professional		$215.68	$464.11	$855.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.42 / $69.39 / $116.05	Professional	26	$41.42	$69.39	$116.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $161.29 / $354.80 / $763.43	Professional	TC	$161.29	$354.80	$763.43
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $256.83 / $341.22 / $1,353.61	Professional		$256.83	$341.22	$1,353.61
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $62.04 / $74.56 / $117.72	Professional	26	$62.04	$74.56	$117.72
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $186.05 / $231.55 / $329.78	Professional	TC	$186.05	$231.55	$329.78
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $231.46 / $274.81 / $678.49	Professional		$231.46	$274.81	$678.49
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.02 / $68.67 / $102.55	Professional	26	$63.02	$68.67	$102.55
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $291.41 / $291.41 / $291.41	Professional	TC	$291.41	$291.41	$291.41
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $74.95 / $126.00 / $398.16	Facility	26	$74.95	$126.00	$398.16
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $222.37 / $425.00 / $1,390.00	Professional		$222.37	$425.00	$1,390.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $57.64 / $119.21 / $286.00	Professional	26	$57.64	$119.21	$286.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $164.72 / $299.00 / $663.78	Professional	TC	$164.72	$299.00	$663.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $68.53 / $258.60 / $607.50	Professional		$68.53	$258.60	$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 $218.94 / $455.85 / $848.98	Professional		$218.94	$455.85	$848.98
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.60 / $69.11 / $116.50	Professional	26	$43.60	$69.11	$116.50
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $161.29 / $354.80 / $761.66	Professional	TC	$161.29	$354.80	$761.66
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 $211.98 / $215.43 / $486.00	Professional		$211.98	$215.43	$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 $155.56 / $159.01 / $421.50	Professional	TC	$155.56	$159.01	$421.50
United Facility/Professional Professional Modifier Low / Median / High Price $206.31 / $312.83 / $666.78	Professional		$206.31	$312.83	$666.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.48 / $67.80 / $119.65	Professional	26	$48.48	$67.80	$119.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $150.06 / $229.50 / $500.06	Professional	TC	$150.06	$229.50	$500.06