Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.20 / $64.17 / $164.00	Facility	26	$58.20	$64.17	$164.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $160.91 / $246.79 / $614.85	Professional		$160.91	$246.79	$614.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.45 / $62.12 / $172.83	Professional	26	$51.45	$62.12	$172.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $106.66 / $146.47 / $321.00	Professional	TC	$106.66	$146.47	$321.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.31 / $115.31 / $115.31	Professional		$115.31	$115.31	$115.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $44.17 / $76.33 / $94.55	Professional	26	$44.17	$76.33	$94.55
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $166.74 / $173.03 / $173.03	Professional		$166.74	$173.03	$173.03
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 $109.34 / $113.47 / $299.79	Professional	TC	$109.34	$113.47	$299.79
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 $157.30 / $311.76 / $556.34	Professional		$157.30	$311.76	$556.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.89 / $70.48 / $114.76	Professional	26	$41.89	$70.48	$114.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.98 / $216.18 / $415.66	Professional	TC	$112.98	$216.18	$415.66
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $200.46 / $265.63 / $804.71	Professional		$200.46	$265.63	$804.71
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 $130.87 / $162.90 / $232.01	Professional	TC	$130.87	$162.90	$232.01
Highmark BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $470.05 / $470.05 / $470.05	Facility	26	$470.05	$470.05	$470.05
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $184.39 / $184.39 / $184.39	Professional		$184.39	$184.39	$184.39
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.14 / $71.01 / $109.56	Professional	26	$64.14	$71.01	$109.56
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $55.42 / $81.76 / $202.34	Facility	26	$55.42	$81.76	$202.34
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $164.38 / $237.52 / $595.00	Professional		$164.38	$237.52	$595.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $54.26 / $74.25 / $164.64	Professional	26	$54.26	$74.25	$164.64
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $108.96 / $155.75 / $413.27	Professional	TC	$108.96	$155.75	$413.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $67.18 / $174.67 / $349.10	Professional		$67.18	$174.67	$349.10
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 $165.17 / $307.01 / $544.26	Professional		$165.17	$307.01	$544.26
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.10 / $70.23 / $117.89	Professional	26	$44.10	$70.23	$117.89
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $113.46 / $215.02 / $400.35	Professional	TC	$113.46	$215.02	$400.35
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 $166.30 / $168.68 / $337.32	Professional		$166.30	$168.68	$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 $109.20 / $111.59 / $271.82	Professional	TC	$109.20	$111.59	$271.82
United Facility/Professional Professional Modifier Low / Median / High Price $170.24 / $250.58 / $401.58	Professional		$170.24	$250.58	$401.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.46 / $67.47 / $113.15	Professional	26	$53.46	$67.47	$113.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $115.04 / $166.18 / $307.22	Professional	TC	$115.04	$166.18	$307.22