Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.84 / $126.00 / $241.92	Facility	26	$90.84	$126.00	$241.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $290.47 / $425.00 / $1,111.50	Professional		$290.47	$425.00	$1,111.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.88 / $126.00 / $307.44	Professional	26	$69.88	$126.00	$307.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $220.59 / $299.00 / $470.23	Professional	TC	$220.59	$299.00	$470.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $201.20 / $201.20 / $322.16	Professional		$201.20	$201.20	$322.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.43 / $100.17 / $113.98	Professional	26	$52.43	$100.17	$113.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $369.61 / $369.61 / $369.61	Professional	TC	$369.61	$369.61	$369.61
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $306.87 / $318.45 / $729.53	Professional		$306.87	$318.45	$729.53
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $69.12 / $88.22 / $136.28	Professional	26	$69.12	$88.22	$136.28
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $237.75 / $246.72 / $593.26	Professional	TC	$237.75	$246.72	$593.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.09 / $79.09 / $79.09	Facility	26	$79.09	$79.09	$79.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $308.99 / $550.69 / $937.76	Professional		$308.99	$550.69	$937.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.20 / $84.20 / $137.55	Professional	26	$50.20	$84.20	$137.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $243.78 / $457.27 / $814.49	Professional	TC	$243.78	$457.27	$814.49
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $372.89 / $495.88 / $1,392.92	Professional		$372.89	$495.88	$1,392.92
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $75.68 / $90.85 / $143.33	Professional	26	$75.68	$90.85	$143.33
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $284.50 / $354.29 / $504.68	Professional	TC	$284.50	$354.29	$504.68
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $387.05 / $406.83 / $669.38	Professional		$387.05	$406.83	$669.38
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $76.90 / $84.59 / $105.10	Professional	26	$76.90	$84.59	$105.10
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $83.75 / $126.00 / $398.16	Facility	26	$83.75	$126.00	$398.16
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $290.47 / $437.51 / $1,362.00	Professional		$290.47	$437.51	$1,362.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $69.88 / $126.00 / $322.00	Professional	26	$69.88	$126.00	$322.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $220.59 / $318.49 / $729.56	Professional	TC	$220.59	$318.49	$729.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $367.06 / $700.00 / $939.20	Professional		$367.06	$700.00	$939.20
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $47.74 / $79.09 / $79.09	Facility	26	$47.74	$79.09	$79.09
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $324.44 / $538.55 / $930.19	Professional		$324.44	$538.55	$930.19
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.70 / $83.75 / $141.69	Professional	26	$52.70	$83.75	$141.69
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $259.24 / $440.43 / $773.01	Professional	TC	$259.24	$440.43	$773.01
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $68.69 / $68.69 / $89.00	Facility	26	$68.69	$68.69	$89.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $281.83 / $288.91 / $511.50	Professional		$281.83	$288.91	$511.50
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $66.91 / $68.73 / $89.00	Professional	26	$66.91	$68.73	$89.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $213.09 / $222.00 / $422.50	Professional	TC	$213.09	$222.00	$422.50
United Facility/Professional Professional Modifier Low / Median / High Price $339.89 / $456.95 / $793.11	Professional		$339.89	$456.95	$793.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.81 / $81.09 / $136.54	Professional	26	$63.81	$81.09	$136.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $276.36 / $380.77 / $689.29	Professional	TC	$276.36	$380.77	$689.29