Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.98 / $145.25 / $303.33	Facility	26	$112.98	$145.25	$303.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $402.08 / $475.00 / $2,650.00	Professional		$402.08	$475.00	$2,650.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.60 / $140.00 / $305.19	Professional	26	$107.60	$140.00	$305.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $282.87 / $348.53 / $638.59	Professional	TC	$282.87	$348.53	$638.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $247.06 / $247.06 / $372.59	Professional		$247.06	$247.06	$372.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $83.12 / $105.37 / $164.85	Professional	26	$83.12	$105.37	$164.85
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $545.48 / $545.48 / $545.48	Professional	TC	$545.48	$545.48	$545.48
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $458.25 / $650.63 / $1,745.08	Professional		$458.25	$650.63	$1,745.08
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $107.36 / $173.95 / $262.58	Professional	26	$107.36	$173.95	$262.58
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $350.89 / $497.14 / $1,545.21	Professional	TC	$350.89	$497.14	$1,545.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $122.33 / $122.33 / $122.33	Facility	26	$122.33	$122.33	$122.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $433.21 / $863.00 / $1,525.44	Professional		$433.21	$863.00	$1,525.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.33 / $130.54 / $211.25	Professional	26	$77.33	$130.54	$211.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $331.93 / $669.73 / $1,288.94	Professional	TC	$331.93	$669.73	$1,288.94
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $556.54 / $740.34 / $2,368.09	Professional		$556.54	$740.34	$2,368.09
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $117.71 / $141.04 / $222.31	Professional	26	$117.71	$141.04	$222.31
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $419.87 / $522.94 / $744.94	Professional	TC	$419.87	$522.94	$744.94
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $515.94 / $953.51 / $991.80	Professional		$515.94	$953.51	$991.80
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $117.42 / $128.71 / $199.58	Professional	26	$117.42	$128.71	$199.58
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $112.98 / $156.01 / $398.16	Facility	26	$112.98	$156.01	$398.16
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $425.00 / $546.25 / $1,695.00	Professional		$425.00	$546.25	$1,695.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $107.60 / $151.91 / $307.44	Professional	26	$107.60	$151.91	$307.44
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $299.00 / $385.24 / $835.14	Professional	TC	$299.00	$385.24	$835.14
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $498.62 / $700.00 / $1,270.30	Professional		$498.62	$700.00	$1,270.30
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $74.04 / $122.33 / $122.33	Facility	26	$74.04	$122.33	$122.33
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $454.88 / $831.35 / $1,508.61	Professional		$454.88	$831.35	$1,508.61
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $80.28 / $130.19 / $211.25	Professional	26	$80.28	$130.19	$211.25
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $353.70 / $647.76 / $1,221.28	Professional	TC	$353.70	$647.76	$1,221.28
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $106.20 / $106.20 / $119.46	Facility	26	$106.20	$106.20	$119.46
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $442.70 / $453.81 / $1,032.50	Professional		$442.70	$453.81	$1,032.50
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $103.15 / $106.25 / $119.46	Professional	26	$103.15	$106.25	$119.46
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $336.45 / $350.66 / $913.04	Professional	TC	$336.45	$350.66	$913.04
United Facility/Professional Professional Modifier Low / Median / High Price $478.88 / $705.30 / $1,168.30	Professional		$478.88	$705.30	$1,168.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.55 / $120.76 / $208.22	Professional	26	$97.55	$120.76	$208.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $365.12 / $537.02 / $1,005.20	Professional	TC	$365.12	$537.02	$1,005.20