Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.72 / $59.08 / $103.87	Facility	26	$47.72	$59.08	$103.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.35 / $181.16 / $877.07	Professional		$123.35	$181.16	$877.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.35 / $52.46 / $152.00	Professional	26	$43.35	$52.46	$152.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.86 / $119.70 / $231.46	Professional	TC	$78.86	$119.70	$231.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.65 / $78.65 / $125.19	Professional		$78.65	$78.65	$125.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.43 / $48.77 / $77.40	Professional	26	$35.43	$48.77	$77.40
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $128.05 / $132.88 / $477.47	Professional		$128.05	$132.88	$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 $81.05 / $119.72 / $374.98	Professional	TC	$81.05	$119.72	$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 $123.83 / $248.42 / $462.34	Professional		$123.83	$248.42	$462.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.71 / $61.92 / $97.95	Professional	26	$35.71	$61.92	$97.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.67 / $168.91 / $335.88	Professional	TC	$83.67	$168.91	$335.88
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $153.59 / $203.25 / $675.73	Professional		$153.59	$203.25	$675.73
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 $96.99 / $120.79 / $172.06	Professional	TC	$96.99	$120.79	$172.06
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $149.66 / $155.63 / $164.63	Professional		$149.66	$155.63	$164.63
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.51 / $63.16 / $101.87	Professional	26	$52.51	$63.16	$101.87
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $151.56 / $151.56 / $151.56	Professional	TC	$151.56	$151.56	$151.56
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $45.45 / $64.98 / $155.80	Facility	26	$45.45	$64.98	$155.80
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $126.00 / $181.16 / $619.23	Professional		$126.00	$181.16	$619.23
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $44.18 / $60.40 / $151.59	Professional	26	$44.18	$60.40	$151.59
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $80.56 / $113.85 / $299.33	Professional	TC	$80.56	$113.85	$299.33
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $53.65 / $123.30 / $325.00	Professional		$53.65	$123.30	$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 $126.84 / $242.49 / $429.39	Professional		$126.84	$242.49	$429.39
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.90 / $62.04 / $100.37	Professional	26	$35.90	$62.04	$100.37
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $84.11 / $167.58 / $335.00	Professional	TC	$84.11	$167.58	$335.00
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 $127.45 / $129.32 / $289.00	Professional		$127.45	$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 $134.36 / $197.69 / $327.84	Professional		$134.36	$197.69	$327.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.30 / $57.88 / $92.86	Professional	26	$45.30	$57.88	$92.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.10 / $133.47 / $243.25	Professional	TC	$90.10	$133.47	$243.25