Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.72 / $122.77 / $299.89	Facility	26	$93.72	$122.77	$299.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.09 / $315.49 / $618.64	Professional		$239.09	$315.49	$618.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.68 / $86.92 / $180.34	Professional	26	$73.68	$86.92	$180.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $159.53 / $213.72 / $403.94	Professional	TC	$159.53	$213.72	$403.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $65.72 / $67.91 / $78.12	Professional	26	$65.72	$67.91	$78.12
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $259.75 / $269.56 / $269.56	Professional		$259.75	$269.56	$269.56
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $84.94 / $137.61 / $210.93	Professional	26	$84.94	$137.61	$210.93
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $174.82 / $221.63 / $750.40	Professional	TC	$174.82	$221.63	$750.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.97 / $96.97 / $96.97	Facility	26	$96.97	$96.97	$96.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $264.17 / $485.11 / $865.79	Professional		$264.17	$485.11	$865.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.37 / $103.90 / $168.10	Professional	26	$61.37	$103.90	$168.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $193.35 / $360.59 / $668.94	Professional	TC	$193.35	$360.59	$668.94
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $312.83 / $415.07 / $1,231.20	Professional		$312.83	$415.07	$1,231.20
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $93.00 / $111.43 / $175.89	Professional	26	$93.00	$111.43	$175.89
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $209.18 / $260.51 / $371.12	Professional	TC	$209.18	$260.51	$371.12
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $94.15 / $103.57 / $111.00	Professional	26	$94.15	$103.57	$111.00
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $93.72 / $157.06 / $306.45	Facility	26	$93.72	$157.06	$306.45
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $244.23 / $345.24 / $957.00	Professional		$244.23	$345.24	$957.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $78.34 / $92.19 / $219.38	Professional	26	$78.34	$92.19	$219.38
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $162.96 / $229.24 / $670.35	Professional	TC	$162.96	$229.24	$670.35
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $93.39 / $325.00 / $556.40	Professional		$93.39	$325.00	$556.40
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $59.48 / $96.97 / $96.97	Facility	26	$59.48	$96.97	$96.97
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $282.23 / $484.08 / $842.84	Professional		$282.23	$484.08	$842.84
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.11 / $101.85 / $173.17	Professional	26	$64.11	$101.85	$173.17
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $199.95 / $349.10 / $626.79	Professional	TC	$199.95	$349.10	$626.79
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $84.01 / $84.01 / $93.41	Facility	26	$84.01	$84.01	$93.41
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $248.67 / $253.13 / $381.83	Professional		$248.67	$253.13	$381.83
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $81.81 / $84.10 / $93.41	Professional	26	$81.81	$84.10	$93.41
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $164.57 / $171.32 / $288.42	Professional	TC	$164.57	$171.32	$288.42
United Facility/Professional Professional Modifier Low / Median / High Price $280.13 / $399.30 / $648.29	Professional		$280.13	$399.30	$648.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.37 / $99.87 / $166.20	Professional	26	$78.37	$99.87	$166.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $200.62 / $283.22 / $507.75	Professional	TC	$200.62	$283.22	$507.75