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 / $103.87	Facility	26	$47.72	$59.09	$103.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.05 / $218.10 / $872.99	Professional		$123.05	$218.10	$872.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.14 / $52.46 / $158.94	Professional	26	$44.14	$52.46	$158.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.56 / $121.07 / $276.17	Professional	TC	$78.56	$121.07	$276.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.81 / $101.30 / $124.87	Professional		$85.81	$101.30	$124.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.15 / $54.68 / $81.50	Professional	26	$36.15	$54.68	$81.50
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $54.54 / $64.13 / $537.76	Professional	26	$54.54	$64.13	$537.76
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $127.73 / $132.55 / $477.47	Professional		$127.73	$132.55	$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 $80.73 / $118.80 / $374.98	Professional	TC	$80.73	$118.80	$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 $123.37 / $245.80 / $461.69	Professional		$123.37	$245.80	$461.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.71 / $62.04 / $97.95	Professional	26	$35.71	$62.04	$97.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.78 / $167.00 / $334.04	Professional	TC	$83.78	$167.00	$334.04
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $153.21 / $202.72 / $674.83	Professional		$153.21	$202.72	$674.83
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 $96.60 / $120.31 / $171.38	Professional	TC	$96.60	$120.31	$171.38
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $148.91 / $163.81 / $167.09	Professional		$148.91	$163.81	$167.09
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.51 / $61.43 / $101.87	Professional	26	$52.51	$61.43	$101.87
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $150.51 / $150.51 / $150.51	Professional	TC	$150.51	$150.51	$150.51
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $52.54 / $60.85 / $114.38	Professional	26	$52.54	$60.85	$114.38
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $45.45 / $65.67 / $155.41	Facility	26	$45.45	$65.67	$155.41
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $125.70 / $181.95 / $732.67	Professional		$125.70	$181.95	$732.67
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $44.18 / $59.85 / $151.69	Professional	26	$44.18	$59.85	$151.69
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $80.25 / $115.00 / $298.20	Professional	TC	$80.25	$115.00	$298.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $53.65 / $122.99 / $325.00	Professional		$53.65	$122.99	$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 $127.81 / $241.27 / $428.31	Professional		$127.81	$241.27	$428.31
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.54 / $62.50 / $100.37	Professional	26	$36.54	$62.50	$100.37
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $83.78 / $166.54 / $323.95	Professional	TC	$83.78	$166.54	$323.95
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 $126.86 / $128.69 / $289.00	Professional		$126.86	$128.69	$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 $80.40 / $82.19 / $227.00	Professional	TC	$80.40	$82.19	$227.00
United Facility/Professional Professional Modifier Low / Median / High Price $134.78 / $194.69 / $333.71	Professional		$134.78	$194.69	$333.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.18 / $56.38 / $93.15	Professional	26	$45.18	$56.38	$93.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.48 / $130.87 / $248.30	Professional	TC	$89.48	$130.87	$248.30