Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.05 / $87.84 / $214.56	Facility	26	$67.05	$87.84	$214.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $188.79 / $235.83 / $383.66	Professional		$188.79	$235.83	$383.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.94 / $60.67 / $92.28	Professional	26	$51.94	$60.67	$92.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $132.03 / $168.78 / $325.76	Professional	TC	$132.03	$168.78	$325.76
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.09 / $61.62 / $93.39	Professional	26	$46.09	$61.62	$93.39
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $193.57 / $200.87 / $335.09	Professional		$193.57	$200.87	$335.09
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $59.75 / $62.01 / $118.64	Professional	26	$59.75	$62.01	$118.64
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $133.81 / $138.86 / $370.72	Professional	TC	$133.81	$138.86	$370.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.70 / $68.70 / $68.70	Facility	26	$68.70	$68.70	$68.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $184.56 / $376.09 / $669.69	Professional		$184.56	$376.09	$669.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.83 / $73.41 / $120.18	Professional	26	$43.83	$73.41	$120.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.19 / $269.18 / $521.52	Professional	TC	$138.19	$269.18	$521.52
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $233.48 / $309.80 / $988.40	Professional		$233.48	$309.80	$988.40
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $65.37 / $78.45 / $123.88	Professional	26	$65.37	$78.45	$123.88
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $160.13 / $199.39 / $284.00	Professional	TC	$160.13	$199.39	$284.00
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $228.44 / $228.44 / $228.44	Professional		$228.44	$228.44	$228.44
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.61 / $66.77 / $87.21	Professional	26	$62.61	$66.77	$87.21
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $67.05 / $110.49 / $219.25	Facility	26	$67.05	$110.49	$219.25
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $192.36 / $235.83 / $541.24	Professional		$192.36	$235.83	$541.24
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $54.56 / $64.69 / $153.43	Professional	26	$54.56	$64.69	$153.43
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $134.46 / $168.78 / $454.61	Professional	TC	$134.46	$168.78	$454.61
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $72.90 / $200.87 / $368.16	Professional		$72.90	$200.87	$368.16
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $41.83 / $68.70 / $68.70	Facility	26	$41.83	$68.70	$68.70
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $191.74 / $359.56 / $649.30	Professional		$191.74	$359.56	$649.30
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.40 / $73.28 / $122.00	Professional	26	$46.40	$73.28	$122.00
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $138.86 / $265.55 / $504.91	Professional	TC	$138.86	$265.55	$504.91
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $59.73 / $59.73 / $68.50	Facility	26	$59.73	$59.73	$68.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $194.62 / $197.56 / $407.00	Professional		$194.62	$197.56	$407.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $58.18 / $59.77 / $68.50	Professional	26	$58.18	$59.77	$68.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $134.85 / $137.83 / $338.50	Professional	TC	$134.85	$137.83	$338.50
United Facility/Professional Professional Modifier Low / Median / High Price $198.95 / $287.38 / $490.40	Professional		$198.95	$287.38	$490.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.38 / $69.81 / $119.98	Professional	26	$56.38	$69.81	$119.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.86 / $207.73 / $393.43	Professional	TC	$138.86	$207.73	$393.43