Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.18 / $69.15 / $155.41	Facility	26	$55.18	$69.15	$155.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $210.89 / $267.55 / $1,183.00	Professional		$210.89	$267.55	$1,183.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.07 / $60.61 / $208.00	Professional	26	$50.07	$60.61	$208.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $159.25 / $205.53 / $331.67	Professional	TC	$159.25	$205.53	$331.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $136.47 / $170.36 / $229.19	Professional		$136.47	$170.36	$229.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.50 / $74.83 / $90.14	Professional	26	$41.50	$74.83	$90.14
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $155.57 / $155.57 / $155.57	Professional	TC	$155.57	$155.57	$155.57
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $222.21 / $354.39 / $705.77	Professional		$222.21	$354.39	$705.77
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $54.71 / $89.16 / $134.94	Professional	26	$54.71	$89.16	$134.94
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $167.50 / $261.16 / $570.82	Professional	TC	$167.50	$261.16	$570.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.89 / $62.89 / $62.89	Facility	26	$62.89	$62.89	$62.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $198.32 / $331.88 / $543.82	Professional		$198.32	$331.88	$543.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.78 / $66.94 / $108.71	Professional	26	$39.78	$66.94	$108.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $150.52 / $254.51 / $448.34	Professional	TC	$150.52	$254.51	$448.34
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $269.47 / $357.96 / $770.52	Professional		$269.47	$357.96	$770.52
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $59.85 / $71.89 / $113.52	Professional	26	$59.85	$71.89	$113.52
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $200.43 / $249.63 / $355.59	Professional	TC	$200.43	$249.63	$355.59
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $264.45 / $288.30 / $302.72	Professional		$264.45	$288.30	$302.72
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.14 / $65.73 / $95.38	Professional	26	$61.14	$65.73	$95.38
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $264.29 / $264.29 / $312.27	Professional	TC	$264.29	$264.29	$312.27
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $55.18 / $77.93 / $180.01	Facility	26	$55.18	$77.93	$180.01
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $215.23 / $293.48 / $832.10	Professional		$215.23	$293.48	$832.10
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $52.02 / $71.73 / $169.47	Professional	26	$52.02	$71.73	$169.47
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $162.66 / $219.65 / $435.44	Professional	TC	$162.66	$219.65	$435.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.44 / $312.43 / $416.83	Professional		$60.44	$312.43	$416.83
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $37.97 / $62.89 / $62.89	Facility	26	$37.97	$62.89	$62.89
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $209.63 / $329.01 / $528.86	Professional		$209.63	$329.01	$528.86
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.24 / $66.86 / $111.76	Professional	26	$41.24	$66.86	$111.76
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $156.35 / $250.88 / $410.84	Professional	TC	$156.35	$250.88	$410.84
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $54.43 / $54.43 / $62.00	Facility	26	$54.43	$54.43	$62.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $218.97 / $224.75 / $324.50	Professional		$218.97	$224.75	$324.50
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $53.04 / $54.45 / $62.00	Professional	26	$53.04	$54.45	$62.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $164.52 / $171.54 / $262.50	Professional	TC	$164.52	$171.54	$262.50
United Facility/Professional Professional Modifier Low / Median / High Price $209.67 / $283.63 / $458.56	Professional		$209.67	$283.63	$458.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.45 / $65.12 / $109.90	Professional	26	$51.45	$65.12	$109.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $157.34 / $218.53 / $349.85	Professional	TC	$157.34	$218.53	$349.85