Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.16 / $126.00 / $398.16	Facility	26	$85.16	$126.00	$398.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $278.00 / $425.00 / $826.35	Professional		$278.00	$425.00	$826.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.15 / $126.00 / $322.00	Professional	26	$85.15	$126.00	$322.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $191.40 / $299.00 / $368.50	Professional	TC	$191.40	$299.00	$368.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $163.78 / $163.78 / $163.78	Professional		$163.78	$163.78	$163.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.37 / $65.67 / $77.97	Professional	26	$64.37	$65.67	$77.97
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $266.02 / $276.07 / $586.34	Professional		$266.02	$276.07	$586.34
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $84.86 / $88.07 / $167.70	Professional	26	$84.86	$88.07	$167.70
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $181.16 / $188.00 / $413.60	Professional	TC	$181.16	$188.00	$413.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.82 / $96.82 / $96.82	Facility	26	$96.82	$96.82	$96.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.94 / $509.41 / $953.22	Professional		$239.94	$509.41	$953.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.20 / $103.86 / $168.10	Professional	26	$61.20	$103.86	$168.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $170.91 / $380.96 / $782.88	Professional	TC	$170.91	$380.96	$782.88
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $320.83 / $426.06 / $1,502.09	Professional		$320.83	$426.06	$1,502.09
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $93.06 / $111.55 / $175.78	Professional	26	$93.06	$111.55	$175.78
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $216.84 / $269.94 / $384.47	Professional	TC	$216.84	$269.94	$384.47
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $313.20 / $313.20 / $313.20	Professional		$313.20	$313.20	$313.20
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $94.15 / $105.71 / $746.20	Professional	26	$94.15	$105.71	$746.20
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $85.16 / $138.60 / $403.20	Facility	26	$85.16	$138.60	$403.20
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $280.42 / $425.00 / $1,320.50	Professional		$280.42	$425.00	$1,320.50
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $85.16 / $126.00 / $307.44	Professional	26	$85.16	$126.00	$307.44
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $195.26 / $299.00 / $639.86	Professional	TC	$195.26	$299.00	$639.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $97.14 / $278.77 / $700.00	Professional		$97.14	$278.77	$700.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $58.79 / $96.82 / $96.82	Facility	26	$58.79	$96.82	$96.82
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $255.93 / $490.23 / $920.46	Professional		$255.93	$490.23	$920.46
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.96 / $103.43 / $172.38	Professional	26	$63.96	$103.43	$172.38
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $179.46 / $380.62 / $782.53	Professional	TC	$179.46	$380.62	$782.53
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $83.94 / $83.94 / $98.00	Facility	26	$83.94	$83.94	$98.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $267.38 / $271.41 / $608.00	Professional		$267.38	$271.41	$608.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $81.76 / $84.01 / $98.00	Professional	26	$81.76	$84.01	$98.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $183.37 / $187.47 / $510.00	Professional	TC	$183.37	$187.47	$510.00
United Facility/Professional Professional Modifier Low / Median / High Price $269.72 / $394.88 / $709.98	Professional		$269.72	$394.88	$709.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.22 / $100.26 / $169.52	Professional	26	$78.22	$100.26	$169.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $189.01 / $260.41 / $573.74	Professional	TC	$189.01	$260.41	$573.74