Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $113.13 / $142.05 / $343.94	Facility	26	$113.13	$142.05	$343.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.89 / $425.00 / $1,650.39	Professional		$331.89	$425.00	$1,650.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.27 / $166.87 / $486.19	Professional	26	$109.27	$166.87	$486.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $220.23 / $299.00 / $422.10	Professional	TC	$220.23	$299.00	$422.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $194.52 / $245.38 / $429.26	Professional		$194.52	$245.38	$429.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $82.77 / $126.83 / $205.70	Professional	26	$82.77	$126.83	$205.70
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $333.82 / $545.16 / $1,805.81	Professional		$333.82	$545.16	$1,805.81
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $115.19 / $176.14 / $298.24	Professional	26	$115.19	$176.14	$298.24
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $218.62 / $361.09 / $1,578.86	Professional	TC	$218.62	$361.09	$1,578.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.22 / $124.22 / $124.22	Facility	26	$124.22	$124.22	$124.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $285.68 / $633.30 / $1,377.82	Professional		$285.68	$633.30	$1,377.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.84 / $139.58 / $223.69	Professional	26	$81.84	$139.58	$223.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $195.20 / $485.47 / $1,157.27	Professional	TC	$195.20	$485.47	$1,157.27
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $380.13 / $504.39 / $2,155.59	Professional		$380.13	$504.39	$2,155.59
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $119.54 / $143.28 / $225.79	Professional	26	$119.54	$143.28	$225.79
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $247.61 / $308.33 / $439.19	Professional	TC	$247.61	$308.33	$439.19
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $350.69 / $407.80 / $655.50	Professional		$350.69	$407.80	$655.50
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $120.78 / $140.00 / $202.72	Professional	26	$120.78	$140.00	$202.72
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $250.19 / $250.19 / $995.35	Professional	TC	$250.19	$250.19	$995.35
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $109.27 / $155.30 / $374.22	Facility	26	$109.27	$155.30	$374.22
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $332.16 / $475.00 / $1,518.82	Professional		$332.16	$475.00	$1,518.82
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $109.27 / $170.73 / $358.34	Professional	26	$109.27	$170.73	$358.34
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $222.88 / $299.00 / $706.02	Professional	TC	$222.88	$299.00	$706.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $124.78 / $328.55 / $700.00	Professional		$124.78	$328.55	$700.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $84.05 / $124.22 / $124.22	Facility	26	$84.05	$124.22	$124.22
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $298.05 / $629.23 / $1,308.83	Professional		$298.05	$629.23	$1,308.83
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $82.28 / $139.94 / $223.69	Professional	26	$82.28	$139.94	$223.69
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $200.88 / $455.33 / $1,153.26	Professional	TC	$200.88	$455.33	$1,153.26
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $107.53 / $107.53 / $133.00	Facility	26	$107.53	$107.53	$133.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $317.63 / $322.17 / $1,051.00	Professional		$317.63	$322.17	$1,051.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $104.78 / $107.58 / $133.00	Professional	26	$104.78	$107.58	$133.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $210.05 / $214.64 / $918.00	Professional	TC	$210.05	$214.64	$918.00
United Facility/Professional Professional Modifier Low / Median / High Price $318.11 / $480.59 / $1,049.78	Professional		$318.11	$480.59	$1,049.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $103.68 / $128.63 / $215.73	Professional	26	$103.68	$128.63	$215.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $216.71 / $305.14 / $819.72	Professional	TC	$216.71	$305.14	$819.72