Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.49 / $130.94 / $403.20	Facility	26	$93.49	$130.94	$403.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $253.53 / $425.00 / $1,552.73	Professional		$253.53	$425.00	$1,552.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.92 / $126.00 / $303.00	Professional	26	$71.92	$126.00	$303.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $179.61 / $288.39 / $368.50	Professional	TC	$179.61	$288.39	$368.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.71 / $54.61 / $65.14	Professional	26	$53.71	$54.61	$65.14
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $242.13 / $251.26 / $726.40	Professional		$242.13	$251.26	$726.40
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $70.81 / $73.48 / $137.19	Professional	26	$70.81	$73.48	$137.19
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $171.32 / $177.78 / $613.70	Professional	TC	$171.32	$177.78	$613.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.40 / $81.40 / $81.40	Facility	26	$81.40	$81.40	$81.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.85 / $493.54 / $888.57	Professional		$239.85	$493.54	$888.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.54 / $76.52 / $134.38	Professional	26	$49.54	$76.52	$134.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.00 / $381.99 / $796.32	Professional	TC	$177.00	$381.99	$796.32
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $292.52 / $388.42 / $1,392.96	Professional		$292.52	$388.42	$1,392.96
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.50 / $93.04 / $146.85	Professional	26	$77.50	$93.04	$146.85
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $205.05 / $255.25 / $363.55	Professional	TC	$205.05	$255.25	$363.55
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $284.70 / $313.17 / $313.17	Professional		$284.70	$313.17	$313.17
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.94 / $88.17 / $135.04	Professional	26	$69.94	$88.17	$135.04
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $93.49 / $138.60 / $412.02	Facility	26	$93.49	$138.60	$412.02
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $253.53 / $425.00 / $1,459.50	Professional		$253.53	$425.00	$1,459.50
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $71.92 / $126.00 / $315.00	Professional	26	$71.92	$126.00	$315.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $181.61 / $299.00 / $729.56	Professional	TC	$181.61	$299.00	$729.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $85.60 / $287.19 / $607.50	Professional		$85.60	$287.19	$607.50
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $39.14 / $81.40 / $81.40	Facility	26	$39.14	$81.40	$81.40
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $245.03 / $487.91 / $876.37	Professional		$245.03	$487.91	$876.37
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.68 / $76.61 / $133.61	Professional	26	$51.68	$76.61	$133.61
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $174.23 / $366.28 / $794.07	Professional	TC	$174.23	$366.28	$794.07
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $64.50 / $70.36 / $70.36	Facility	26	$64.50	$70.36	$70.36
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $242.44 / $246.11 / $486.00	Professional		$242.44	$246.11	$486.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $64.50 / $70.36 / $72.95	Professional	26	$64.50	$70.36	$72.95
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $172.04 / $175.75 / $421.50	Professional	TC	$172.04	$175.75	$421.50
United Facility/Professional Professional Modifier Low / Median / High Price $237.43 / $371.32 / $625.66	Professional		$237.43	$371.32	$625.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.17 / $79.28 / $139.78	Professional	26	$54.17	$79.28	$139.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.06 / $255.77 / $530.16	Professional	TC	$165.06	$255.77	$530.16