Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.98 / $127.23 / $398.16	Facility	26	$117.98	$127.23	$398.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $282.87 / $425.00 / $577.30	Professional		$282.87	$425.00	$577.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.02 / $126.00 / $230.63	Professional	26	$85.02	$126.00	$230.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $195.98 / $289.48 / $368.50	Professional	TC	$195.98	$289.48	$368.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $166.70 / $166.70 / $182.33	Professional		$166.70	$166.70	$182.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $65.91 / $65.91 / $87.51	Professional	26	$65.91	$65.91	$87.51
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $270.80 / $358.59 / $593.39	Professional		$270.80	$358.59	$593.39
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $85.18 / $110.40 / $167.70	Professional	26	$85.18	$110.40	$167.70
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $185.62 / $248.19 / $420.65	Professional	TC	$185.62	$248.19	$420.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.16 / $97.16 / $97.16	Facility	26	$97.16	$97.16	$97.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $242.93 / $526.85 / $968.50	Professional		$242.93	$526.85	$968.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.26 / $106.98 / $173.03	Professional	26	$63.26	$106.98	$173.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $175.11 / $381.47 / $786.67	Professional	TC	$175.11	$381.47	$786.67
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $326.73 / $433.94 / $1,517.63	Professional		$326.73	$433.94	$1,517.63
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $93.44 / $112.03 / $176.44	Professional	26	$93.44	$112.03	$176.44
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $222.16 / $276.58 / $393.93	Professional	TC	$222.16	$276.58	$393.93
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $318.83 / $318.83 / $318.83	Professional		$318.83	$318.83	$318.83
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $94.53 / $105.27 / $805.35	Professional	26	$94.53	$105.27	$805.35
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $117.98 / $127.23 / $403.20	Facility	26	$117.98	$127.23	$403.20
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $285.62 / $425.00 / $1,192.00	Professional		$285.62	$425.00	$1,192.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $85.49 / $126.00 / $241.40	Professional	26	$85.49	$126.00	$241.40
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $200.14 / $299.00 / $537.11	Professional	TC	$200.14	$299.00	$537.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $97.90 / $283.60 / $700.00	Professional		$97.90	$283.60	$700.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $63.35 / $97.16 / $97.16	Facility	26	$63.35	$97.16	$97.16
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $255.47 / $502.60 / $931.41	Professional		$255.47	$502.60	$931.41
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.23 / $107.12 / $173.03	Professional	26	$64.23	$107.12	$173.03
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $177.12 / $381.47 / $783.04	Professional	TC	$177.12	$381.47	$783.04
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $84.26 / $84.26 / $100.00	Facility	26	$84.26	$84.26	$100.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $272.02 / $276.14 / $595.00	Professional		$272.02	$276.14	$595.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $82.07 / $84.32 / $100.00	Professional	26	$82.07	$84.32	$100.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $187.70 / $191.90 / $495.00	Professional	TC	$187.70	$191.90	$495.00
United Facility/Professional Professional Modifier Low / Median / High Price $273.98 / $395.75 / $725.77	Professional		$273.98	$395.75	$725.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.80 / $100.66 / $166.74	Professional	26	$80.80	$100.66	$166.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $192.97 / $278.54 / $589.66	Professional	TC	$192.97	$278.54	$589.66