Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.65 / $109.00 / $304.77	Facility	26	$86.65	$109.00	$304.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.16 / $374.41 / $1,362.45	Professional		$245.16	$374.41	$1,362.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.06 / $95.24 / $325.89	Professional	26	$79.06	$95.24	$325.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $159.21 / $224.76 / $561.36	Professional	TC	$159.21	$224.76	$561.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $176.00 / $213.55 / $226.03	Professional		$176.00	$213.55	$226.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $66.70 / $92.82 / $142.40	Professional	26	$66.70	$92.82	$142.40
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $162.63 / $162.63 / $162.63	Professional	TC	$162.63	$162.63	$162.63
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $100.06 / $134.04 / $983.36	Professional	26	$100.06	$134.04	$983.36
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $261.36 / $271.23 / $271.23	Professional		$261.36	$271.23	$271.23
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $86.23 / $108.33 / $169.71	Professional	26	$86.23	$108.33	$169.71
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $175.13 / $181.74 / $373.33	Professional	TC	$175.13	$181.74	$373.33
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.41 / $98.41 / $98.41	Facility	26	$98.41	$98.41	$98.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $244.48 / $496.23 / $888.82	Professional		$244.48	$496.23	$888.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.01 / $106.73 / $175.81	Professional	26	$63.01	$106.73	$175.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $179.97 / $355.55 / $648.15	Professional	TC	$179.97	$355.55	$648.15
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $314.83 / $417.94 / $1,275.58	Professional		$314.83	$417.94	$1,275.58
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $94.50 / $113.28 / $178.62	Professional	26	$94.50	$113.28	$178.62
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $209.61 / $260.94 / $371.65	Professional	TC	$209.61	$260.94	$371.65
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.17 / $337.79 / $358.91	Professional		$302.17	$337.79	$358.91
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $94.14 / $103.59 / $149.84	Professional	26	$94.14	$103.59	$149.84
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $297.95 / $297.95 / $297.95	Professional	TC	$297.95	$297.95	$297.95
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $90.62 / $134.04 / $983.36	Professional	26	$90.62	$134.04	$983.36
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $86.65 / $119.67 / $311.44	Facility	26	$86.65	$119.67	$311.44
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $245.16 / $367.14 / $1,180.26	Professional		$245.16	$367.14	$1,180.26
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $80.79 / $97.62 / $275.00	Professional	26	$80.79	$97.62	$275.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $162.63 / $234.61 / $638.42	Professional	TC	$162.63	$234.61	$638.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $98.43 / $264.33 / $470.42	Professional		$98.43	$264.33	$470.42
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $98.41 / $98.41	Facility	26	$63.10	$98.41	$98.41
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $261.86 / $462.00 / $851.43	Professional		$261.86	$462.00	$851.43
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $65.16 / $105.11 / $175.81	Professional	26	$65.16	$105.11	$175.81
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $180.51 / $324.07 / $631.97	Professional	TC	$180.51	$324.07	$631.97
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $85.30 / $85.30 / $99.20	Facility	26	$85.30	$85.30	$99.20
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $249.93 / $254.41 / $399.39	Professional		$249.93	$254.41	$399.39
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $83.08 / $85.37 / $99.20	Professional	26	$83.08	$85.37	$99.20
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $164.57 / $171.32 / $300.19	Professional	TC	$164.57	$171.32	$300.19
United Facility/Professional Professional Modifier Low / Median / High Price $263.41 / $385.22 / $629.10	Professional		$263.41	$385.22	$629.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.20 / $101.86 / $168.74	Professional	26	$82.20	$101.86	$168.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $181.10 / $261.58 / $483.07	Professional	TC	$181.10	$261.58	$483.07