Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.88 / $74.13 / $130.63	Facility	26	$59.88	$74.13	$130.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $188.16 / $275.00 / $599.36	Professional		$188.16	$275.00	$599.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.83 / $66.01 / $194.59	Professional	26	$55.83	$66.01	$194.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $132.33 / $174.72 / $362.00	Professional	TC	$132.33	$174.72	$362.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $119.62 / $141.03 / $160.63	Professional		$119.62	$141.03	$160.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.80 / $68.70 / $97.38	Professional	26	$44.80	$68.70	$97.38
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $192.88 / $200.16 / $200.16	Professional		$192.88	$200.16	$200.16
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $59.06 / $95.71 / $160.13	Professional	26	$59.06	$95.71	$160.13
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $133.81 / $225.25 / $561.29	Professional	TC	$133.81	$225.25	$561.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.54 / $67.54 / $67.54	Facility	26	$67.54	$67.54	$67.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.74 / $374.25 / $680.02	Professional		$186.74	$374.25	$680.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.68 / $76.81 / $127.65	Professional	26	$44.68	$76.81	$127.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.19 / $267.70 / $522.08	Professional	TC	$138.19	$267.70	$522.08
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $232.73 / $308.86 / $998.96	Professional		$232.73	$308.86	$998.96
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.65 / $77.59 / $122.47	Professional	26	$64.65	$77.59	$122.47
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $160.13 / $199.39 / $284.00	Professional	TC	$160.13	$199.39	$284.00
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $226.66 / $235.60 / $249.44	Professional		$226.66	$235.60	$249.44
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.64 / $69.66 / $86.26	Professional	26	$65.64	$69.66	$86.26
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $209.20 / $209.20 / $209.20	Professional	TC	$209.20	$209.20	$209.20
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $59.88 / $82.69 / $185.22	Facility	26	$59.88	$82.69	$185.22
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $192.21 / $273.36 / $706.23	Professional		$192.21	$273.36	$706.23
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $55.88 / $74.66 / $189.08	Professional	26	$55.88	$74.66	$189.08
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $135.18 / $179.26 / $502.40	Professional	TC	$135.18	$179.26	$502.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $67.42 / $192.76 / $358.20	Professional		$67.42	$192.76	$358.20
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $45.13 / $67.54 / $67.54	Facility	26	$45.13	$67.54	$67.54
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $191.39 / $356.62 / $650.55	Professional		$191.39	$356.62	$650.55
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.34 / $77.08 / $132.88	Professional	26	$45.34	$77.08	$132.88
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $138.86 / $257.72 / $505.42	Professional	TC	$138.86	$257.72	$505.42
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $58.43 / $58.43 / $73.50	Facility	26	$58.43	$58.43	$73.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $192.97 / $195.94 / $412.50	Professional		$192.97	$195.94	$412.50
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $56.96 / $58.43 / $73.50	Professional	26	$56.96	$58.43	$73.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $134.54 / $137.51 / $339.00	Professional	TC	$134.54	$137.51	$339.00
United Facility/Professional Professional Modifier Low / Median / High Price $201.61 / $291.20 / $479.64	Professional		$201.61	$291.20	$479.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.81 / $75.83 / $127.77	Professional	26	$59.81	$75.83	$127.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $139.38 / $198.36 / $376.20	Professional	TC	$139.38	$198.36	$376.20