Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.52 / $126.74 / $398.16	Facility	26	$117.52	$126.74	$398.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $279.12 / $425.00 / $1,459.50	Professional		$279.12	$425.00	$1,459.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.16 / $126.00 / $232.54	Professional	26	$85.16	$126.00	$232.54
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $138.18 / $200.00 / $237.50	Professional	52	$138.18	$200.00	$237.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $191.65 / $299.00 / $422.10	Professional	TC	$191.65	$299.00	$422.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $163.76 / $179.11 / $188.20	Professional		$163.76	$179.11	$188.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.89 / $119.19 / $138.83	Professional	26	$63.89	$119.19	$138.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $180.59 / $180.59 / $180.59	Professional	TC	$180.59	$180.59	$180.59
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $266.35 / $444.54 / $1,010.38	Professional		$266.35	$444.54	$1,010.38
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $84.23 / $137.50 / $207.50	Professional	26	$84.23	$137.50	$207.50
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $182.12 / $307.04 / $852.45	Professional	TC	$182.12	$307.04	$852.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.46 / $96.46 / $96.46	Facility	26	$96.46	$96.46	$96.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $240.35 / $511.39 / $957.73	Professional		$240.35	$511.39	$957.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.20 / $103.30 / $168.10	Professional	26	$61.20	$103.30	$168.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $171.81 / $381.72 / $784.42	Professional	TC	$171.81	$381.72	$784.42
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $321.10 / $425.97 / $1,504.78	Professional		$321.10	$425.97	$1,504.78
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $92.18 / $110.71 / $174.72	Professional	26	$92.18	$110.71	$174.72
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $217.97 / $271.36 / $386.50	Professional	TC	$217.97	$271.36	$386.50
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $312.83 / $312.83 / $312.83	Professional		$312.83	$312.83	$312.83
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.78 / $103.16 / $157.40	Professional	26	$93.78	$103.16	$157.40
Highmark BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $270.02 / $270.02 / $270.02	Professional	52	$270.02	$270.02	$270.02
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $117.52 / $138.60 / $403.20	Facility	26	$117.52	$138.60	$403.20
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $279.12 / $437.75 / $1,362.00	Professional		$279.12	$437.75	$1,362.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $85.16 / $128.66 / $279.72	Professional	26	$85.16	$128.66	$279.72
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $139.56 / $212.50 / $352.75	Professional	52	$139.56	$212.50	$352.75
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $193.96 / $299.00 / $689.84	Professional	TC	$193.96	$299.00	$689.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $101.81 / $288.41 / $700.00	Professional		$101.81	$288.41	$700.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $58.54 / $96.46 / $96.46	Facility	26	$58.54	$96.46	$96.46
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $254.47 / $493.55 / $922.00	Professional		$254.47	$493.55	$922.00
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.96 / $103.04 / $172.38	Professional	26	$63.96	$103.04	$172.38
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $178.79 / $381.72 / $784.05	Professional	TC	$178.79	$381.72	$784.05
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $83.94 / $83.94 / $97.00	Facility	26	$83.94	$83.94	$97.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $267.48 / $271.39 / $607.50	Professional		$267.48	$271.39	$607.50
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $81.76 / $84.01 / $97.00	Professional	26	$81.76	$84.01	$97.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $183.47 / $187.45 / $510.50	Professional	TC	$183.47	$187.45	$510.50
United Facility/Professional Professional Modifier Low / Median / High Price $268.20 / $395.55 / $718.44	Professional		$268.20	$395.55	$718.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $95.53 / $165.46	Professional	26	$77.62	$95.53	$165.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $187.49 / $274.89 / $611.23	Professional	TC	$187.49	$274.89	$611.23