Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $113.13 / $138.60 / $249.47	Facility	26	$113.13	$138.60	$249.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $330.58 / $425.00 / $1,491.69	Professional		$330.58	$425.00	$1,491.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $108.70 / $157.83 / $382.37	Professional	26	$108.70	$157.83	$382.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.95 / $299.00 / $729.56	Professional	TC	$218.95	$299.00	$729.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $193.74 / $217.96 / $307.77	Professional		$193.74	$217.96	$307.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $82.77 / $143.96 / $191.94	Professional	26	$82.77	$143.96	$191.94
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $203.93 / $203.93 / $203.93	Professional	TC	$203.93	$203.93	$203.93
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $344.35 / $542.99 / $1,788.31	Professional		$344.35	$542.99	$1,788.31
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $119.31 / $176.14 / $275.20	Professional	26	$119.31	$176.14	$275.20
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $225.04 / $380.42 / $1,578.86	Professional	TC	$225.04	$380.42	$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 $284.05 / $642.59 / $1,374.44	Professional		$284.05	$642.59	$1,374.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.52 / $135.36 / $216.89	Professional	26	$78.52	$135.36	$216.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.00 / $471.99 / $1,172.06	Professional	TC	$194.00	$471.99	$1,172.06
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $378.54 / $502.29 / $2,204.21	Professional		$378.54	$502.29	$2,204.21
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 $246.10 / $306.43 / $436.48	Professional	TC	$246.10	$306.43	$436.48
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $349.27 / $376.11 / $653.05	Professional		$349.27	$376.11	$653.05
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $120.78 / $132.83 / $192.02	Professional	26	$120.78	$132.83	$192.02
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $323.30 / $323.30 / $665.91	Professional	TC	$323.30	$323.30	$665.91
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $109.26 / $155.30 / $316.22	Facility	26	$109.26	$155.30	$316.22
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $330.86 / $475.00 / $1,477.00	Professional		$330.86	$475.00	$1,477.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $109.26 / $161.00 / $336.79	Professional	26	$109.26	$161.00	$336.79
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $221.58 / $305.77 / $783.89	Professional	TC	$221.58	$305.77	$783.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $124.78 / $328.03 / $700.00	Professional		$124.78	$328.03	$700.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $77.68 / $124.22 / $124.22	Facility	26	$77.68	$124.22	$124.22
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $302.79 / $630.99 / $1,308.02	Professional		$302.79	$630.99	$1,308.02
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.84 / $134.69 / $221.45	Professional	26	$81.84	$134.69	$221.45
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $203.70 / $452.88 / $1,132.36	Professional	TC	$203.70	$452.88	$1,132.36
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $107.53 / $107.53 / $122.00	Facility	26	$107.53	$107.53	$122.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $316.39 / $320.89 / $1,040.00	Professional		$316.39	$320.89	$1,040.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $104.78 / $107.58 / $122.00	Professional	26	$104.78	$107.58	$122.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $208.81 / $213.38 / $918.00	Professional	TC	$208.81	$213.38	$918.00
United Facility/Professional Professional Modifier Low / Median / High Price $316.89 / $447.37 / $1,039.28	Professional		$316.89	$447.37	$1,039.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.39 / $126.72 / $213.12	Professional	26	$100.39	$126.72	$213.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $215.49 / $296.89 / $852.17	Professional	TC	$215.49	$296.89	$852.17