Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.03 / $81.76 / $164.00	Facility	26	$64.03	$81.76	$164.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.49 / $275.00 / $674.68	Professional		$213.49	$275.00	$674.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.41 / $59.29 / $127.70	Professional	26	$51.41	$59.29	$127.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $159.22 / $203.52 / $362.21	Professional	TC	$159.22	$203.52	$362.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $150.56 / $178.25 / $204.88	Professional		$150.56	$178.25	$204.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.28 / $44.17 / $50.35	Professional	26	$43.28	$44.17	$50.35
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $232.21 / $240.98 / $386.85	Professional		$232.21	$240.98	$386.85
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $57.40 / $93.53 / $141.13	Professional	26	$57.40	$93.53	$141.13
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $174.82 / $181.41 / $707.36	Professional	TC	$174.82	$181.41	$707.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.64 / $65.64 / $65.64	Facility	26	$65.64	$65.64	$65.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.73 / $399.15 / $670.94	Professional		$218.73	$399.15	$670.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.89 / $70.48 / $114.76	Professional	26	$41.89	$70.48	$114.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $170.46 / $309.41 / $548.61	Professional	TC	$170.46	$309.41	$548.61
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $281.52 / $373.89 / $969.09	Professional		$281.52	$373.89	$969.09
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $62.76 / $75.43 / $119.13	Professional	26	$62.76	$75.43	$119.13
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 Low / Median / High Price $291.83 / $291.83 / $291.83	Professional		$291.83	$291.83	$291.83
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.77 / $63.77 / $72.06	Professional	26	$63.77	$63.77	$72.06
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $64.03 / $86.22 / $204.90	Facility	26	$64.03	$86.22	$204.90
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $218.08 / $289.70 / $706.57	Professional		$218.08	$289.70	$706.57
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $54.26 / $63.62 / $146.27	Professional	26	$54.26	$63.62	$146.27
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $162.65 / $224.56 / $440.55	Professional	TC	$162.65	$224.56	$440.55
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $63.27 / $325.00 / $501.40	Professional		$63.27	$325.00	$501.40
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $39.86 / $65.64 / $65.64	Facility	26	$39.86	$65.64	$65.64
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $231.36 / $389.87 / $666.72	Professional		$231.36	$389.87	$666.72
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.10 / $70.23 / $117.89	Professional	26	$44.10	$70.23	$117.89
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $177.21 / $300.95 / $528.09	Professional	TC	$177.21	$300.95	$528.09
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $57.10 / $57.10 / $65.50	Facility	26	$57.10	$57.10	$65.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $221.93 / $227.36 / $390.50	Professional		$221.93	$227.36	$390.50
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $55.65 / $57.10 / $65.50	Professional	26	$55.65	$57.10	$65.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $164.83 / $171.71 / $325.00	Professional	TC	$164.83	$171.71	$325.00
United Facility/Professional Professional Modifier Low / Median / High Price $235.68 / $327.33 / $517.03	Professional		$235.68	$327.33	$517.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.07 / $68.04 / $113.65	Professional	26	$53.07	$68.04	$113.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $180.48 / $251.49 / $417.68	Professional	TC	$180.48	$251.49	$417.68