Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.50 / $127.32 / $398.16	Facility	26	$118.50	$127.32	$398.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $343.70 / $425.00 / $936.13	Professional		$343.70	$425.00	$936.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.87 / $126.00 / $389.19	Professional	26	$85.87	$126.00	$389.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.08 / $299.00 / $469.86	Professional	TC	$257.08	$299.00	$469.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.87 / $139.62 / $159.66	Professional	26	$62.87	$139.62	$159.66
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $326.50 / $547.19 / $871.24	Professional		$326.50	$547.19	$871.24
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $84.62 / $138.12 / $210.93	Professional	26	$84.62	$138.12	$210.93
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $241.87 / $409.07 / $710.76	Professional	TC	$241.87	$409.07	$710.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.95 / $96.95 / $96.95	Facility	26	$96.95	$96.95	$96.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $299.72 / $567.66 / $949.19	Professional		$299.72	$567.66	$949.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.64 / $105.13 / $173.17	Professional	26	$61.64	$105.13	$173.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $228.18 / $447.62 / $770.75	Professional	TC	$228.18	$447.62	$770.75
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $395.47 / $525.42 / $1,385.84	Professional		$395.47	$525.42	$1,385.84
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $92.51 / $111.06 / $175.52	Professional	26	$92.51	$111.06	$175.52
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $289.49 / $360.39 / $513.29	Professional	TC	$289.49	$360.39	$513.29
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $386.35 / $670.09 / $697.00	Professional		$386.35	$670.09	$697.00
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $94.15 / $101.22 / $139.57	Professional	26	$94.15	$101.22	$139.57
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $450.92 / $450.92 / $450.92	Professional	TC	$450.92	$450.92	$450.92
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $118.50 / $138.60 / $403.20	Facility	26	$118.50	$138.60	$403.20
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $346.09 / $465.11 / $1,362.00	Professional		$346.09	$465.11	$1,362.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $85.87 / $128.85 / $374.22	Professional	26	$85.87	$128.85	$374.22
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $260.22 / $324.02 / $688.70	Professional	TC	$260.22	$324.02	$688.70
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $389.04 / $700.00 / $960.40	Professional		$389.04	$700.00	$960.40
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $59.48 / $96.95 / $96.95	Facility	26	$59.48	$96.95	$96.95
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $308.02 / $551.40 / $920.15	Professional		$308.02	$551.40	$920.15
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.38 / $103.90 / $173.17	Professional	26	$64.38	$103.90	$173.17
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $233.72 / $413.11 / $765.04	Professional	TC	$233.72	$413.11	$765.04
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $84.32 / $84.32 / $95.99	Facility	26	$84.32	$84.32	$95.99
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $328.76 / $334.06 / $505.00	Professional		$328.76	$334.06	$505.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $82.12 / $84.41 / $95.99	Professional	26	$82.12	$84.41	$95.99
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $244.36 / $249.74 / $409.01	Professional	TC	$244.36	$249.74	$409.01
United Facility/Professional Professional Modifier Low / Median / High Price $331.61 / $454.78 / $746.91	Professional		$331.61	$454.78	$746.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.14 / $100.26 / $166.87	Professional	26	$73.14	$100.26	$166.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $237.73 / $353.95 / $659.13	Professional	TC	$237.73	$353.95	$659.13