Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.20 / $76.48 / $164.00	Facility	26	$58.20	$76.48	$164.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $160.91 / $215.66 / $520.83	Professional		$160.91	$215.66	$520.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.41 / $61.24 / $164.64	Professional	26	$51.41	$61.24	$164.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $106.66 / $141.41 / $299.24	Professional	TC	$106.66	$141.41	$299.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.54 / $52.83 / $89.67	Professional	26	$43.54	$52.83	$89.67
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $166.10 / $172.37 / $172.37	Professional		$166.10	$172.37	$172.37
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $57.40 / $59.57 / $114.02	Professional	26	$57.40	$59.57	$114.02
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $108.70 / $112.80 / $300.42	Professional	TC	$108.70	$112.80	$300.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.98 / $65.98 / $65.98	Facility	26	$65.98	$65.98	$65.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $156.69 / $316.20 / $556.34	Professional		$156.69	$316.20	$556.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.89 / $70.23 / $114.76	Professional	26	$41.89	$70.23	$114.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.57 / $218.34 / $433.55	Professional	TC	$109.57	$218.34	$433.55
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $199.68 / $264.58 / $805.59	Professional		$199.68	$264.58	$805.59
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $62.76 / $75.43 / $119.13	Professional	26	$62.76	$75.43	$119.13
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $130.12 / $161.94 / $230.65	Professional	TC	$130.12	$161.94	$230.65
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $225.07 / $225.07 / $225.07	Professional		$225.07	$225.07	$225.07
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.14 / $70.56 / $107.66	Professional	26	$64.14	$70.56	$107.66
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $58.20 / $81.76 / $202.34	Facility	26	$58.20	$81.76	$202.34
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $164.38 / $233.33 / $585.72	Professional		$164.38	$233.33	$585.72
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $54.26 / $73.45 / $164.64	Professional	26	$54.26	$73.45	$164.64
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $108.96 / $145.62 / $414.94	Professional	TC	$108.96	$145.62	$414.94
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $66.98 / $174.33 / $347.74	Professional		$66.98	$174.33	$347.74
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $39.86 / $65.98 / $65.98	Facility	26	$39.86	$65.98	$65.98
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $163.36 / $306.73 / $543.69	Professional		$163.36	$306.73	$543.69
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.62 / $69.69 / $117.89	Professional	26	$43.62	$69.69	$117.89
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $109.57 / $216.03 / $416.15	Professional	TC	$109.57	$216.03	$416.15
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $57.10 / $57.10 / $65.50	Facility	26	$57.10	$57.10	$65.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $165.99 / $168.37 / $337.32	Professional		$165.99	$168.37	$337.32
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $55.65 / $57.10 / $65.50	Professional	26	$55.65	$57.10	$65.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $108.89 / $111.27 / $271.82	Professional	TC	$108.89	$111.27	$271.82
United Facility/Professional Professional Modifier Low / Median / High Price $169.94 / $262.29 / $436.95	Professional		$169.94	$262.29	$436.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.15 / $67.45 / $114.85	Professional	26	$54.15	$67.45	$114.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $112.81 / $158.09 / $305.62	Professional	TC	$112.81	$158.09	$305.62