Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.72 / $59.09 / $155.41	Facility	26	$47.72	$59.09	$155.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.31 / $218.10 / $682.00	Professional		$126.31	$218.10	$682.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.27 / $52.59 / $168.86	Professional	26	$43.27	$52.59	$168.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.16 / $119.70 / $293.55	Professional	TC	$79.16	$119.70	$293.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $86.24 / $98.56 / $125.50	Professional		$86.24	$98.56	$125.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.43 / $44.04 / $77.40	Professional	26	$35.43	$44.04	$77.40
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $54.54 / $64.13 / $507.22	Professional	26	$54.54	$64.13	$507.22
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $128.37 / $133.21 / $477.47	Professional		$128.37	$133.21	$477.47
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $47.00 / $76.17 / $134.72	Professional	26	$47.00	$76.17	$134.72
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $81.37 / $135.66 / $374.98	Professional	TC	$81.37	$135.66	$374.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $54.02	Facility	26	$54.02	$54.02	$54.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.29 / $247.01 / $462.99	Professional		$126.29	$247.01	$462.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.71 / $62.04 / $99.12	Professional	26	$35.71	$62.04	$99.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $84.44 / $168.36 / $337.73	Professional	TC	$84.44	$168.36	$337.73
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $153.99 / $203.76 / $676.62	Professional		$153.99	$203.76	$676.62
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.38 / $61.75 / $97.55	Professional	26	$51.38	$61.75	$97.55
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $97.37 / $121.25 / $172.72	Professional	TC	$97.37	$121.25	$172.72
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $150.04 / $156.03 / $169.60	Professional		$150.04	$156.03	$169.60
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.51 / $65.26 / $88.14	Professional	26	$52.51	$65.26	$88.14
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $126.79 / $151.69 / $152.15	Professional	TC	$126.79	$151.69	$152.15
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $49.40 / $64.13 / $122.30	Professional	26	$49.40	$64.13	$122.30
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $45.45 / $65.90 / $155.80	Facility	26	$45.45	$65.90	$155.80
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $126.31 / $190.90 / $624.41	Professional		$126.31	$190.90	$624.41
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $43.47 / $55.45 / $154.08	Professional	26	$43.47	$55.45	$154.08
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $80.86 / $115.96 / $300.50	Professional	TC	$80.86	$115.96	$300.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $53.65 / $123.60 / $325.00	Professional		$53.65	$123.60	$325.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $37.97 / $54.02 / $54.02	Facility	26	$37.97	$54.02	$54.02
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $128.38 / $242.49 / $430.47	Professional		$128.38	$242.49	$430.47
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.54 / $63.07 / $101.06	Professional	26	$36.54	$63.07	$101.06
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $84.44 / $168.22 / $325.48	Professional	TC	$84.44	$168.22	$325.48
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $46.50 / $46.50 / $62.00	Facility	26	$46.50	$46.50	$62.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $127.48 / $129.32 / $289.00	Professional		$127.48	$129.32	$289.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $45.37 / $46.50 / $62.00	Professional	26	$45.37	$46.50	$62.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $81.02 / $82.83 / $227.00	Professional	TC	$81.02	$82.83	$227.00
United Facility/Professional Professional Modifier Low / Median / High Price $135.40 / $203.68 / $325.93	Professional		$135.40	$203.68	$325.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.30 / $57.18 / $95.14	Professional	26	$45.30	$57.18	$95.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.10 / $130.13 / $243.17	Professional	TC	$90.10	$130.13	$243.17