Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.48 / $126.00 / $249.47	Facility	26	$90.48	$126.00	$249.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $355.45 / $425.00 / $2,205.48	Professional		$355.45	$425.00	$2,205.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.18 / $140.00 / $389.19	Professional	26	$86.18	$140.00	$389.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $266.08 / $299.00 / $461.90	Professional	TC	$266.08	$299.00	$461.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $208.26 / $234.29 / $332.76	Professional		$208.26	$234.29	$332.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.41 / $120.17 / $150.32	Professional	26	$64.41	$120.17	$150.32
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $338.87 / $565.28 / $1,549.88	Professional		$338.87	$565.28	$1,549.88
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $84.92 / $138.61 / $209.24	Professional	26	$84.92	$138.61	$209.24
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $253.95 / $426.68 / $1,390.62	Professional	TC	$253.95	$426.68	$1,390.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.25 / $97.25 / $97.25	Facility	26	$97.25	$97.25	$97.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $335.67 / $725.00 / $1,491.88	Professional		$335.67	$725.00	$1,491.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.95 / $104.27 / $169.39	Professional	26	$61.95	$104.27	$169.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $262.31 / $597.30 / $1,276.61	Professional	TC	$262.31	$597.30	$1,276.61
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $410.84 / $545.99 / $2,277.80	Professional		$410.84	$545.99	$2,277.80
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $92.91 / $111.58 / $176.15	Professional	26	$92.91	$111.58	$176.15
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $303.93 / $378.40 / $538.98	Professional	TC	$303.93	$378.40	$538.98
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $399.86 / $439.70 / $1,003.89	Professional		$399.86	$439.70	$1,003.89
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $89.36 / $101.02 / $134.00	Professional	26	$89.36	$101.02	$134.00
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $90.48 / $127.77 / $398.16	Facility	26	$90.48	$127.77	$398.16
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $355.49 / $475.00 / $1,477.00	Professional		$355.49	$475.00	$1,477.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $86.18 / $140.00 / $322.00	Professional	26	$86.18	$140.00	$322.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $269.31 / $335.00 / $729.56	Professional	TC	$269.31	$335.00	$729.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $102.62 / $396.64 / $1,158.90	Professional		$102.62	$396.64	$1,158.90
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $59.00 / $97.25 / $97.25	Facility	26	$59.00	$97.25	$97.25
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $346.25 / $715.74 / $1,421.71	Professional		$346.25	$715.74	$1,421.71
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.69 / $103.96 / $174.13	Professional	26	$64.69	$103.96	$174.13
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $261.19 / $597.30 / $1,213.50	Professional	TC	$261.19	$597.30	$1,213.50
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $84.62 / $84.62 / $95.50	Facility	26	$84.62	$84.62	$95.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $339.55 / $345.10 / $924.50	Professional		$339.55	$345.10	$924.50
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $82.42 / $84.69 / $95.50	Professional	26	$82.42	$84.69	$95.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $254.86 / $260.49 / $829.00	Professional	TC	$254.86	$260.49	$829.00
United Facility/Professional Professional Modifier Low / Median / High Price $336.52 / $514.66 / $1,037.22	Professional		$336.52	$514.66	$1,037.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.59 / $100.66 / $176.24	Professional	26	$72.59	$100.66	$176.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $239.58 / $383.95 / $906.82	Professional	TC	$239.58	$383.95	$906.82