Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.38 / $126.00 / $398.16	Facility	26	$118.38	$126.00	$398.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $276.87 / $425.00 / $550.00	Professional		$276.87	$425.00	$550.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.78 / $119.21 / $161.00	Professional	26	$82.78	$119.21	$161.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $192.05 / $284.23 / $368.50	Professional	TC	$192.05	$284.23	$368.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.33 / $162.33 / $202.92	Professional		$162.33	$162.33	$202.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.86 / $62.89 / $84.15	Professional	26	$61.86	$62.89	$84.15
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $264.00 / $273.97 / $726.57	Professional		$264.00	$273.97	$726.57
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $81.56 / $84.63 / $162.46	Professional	26	$81.56	$84.63	$162.46
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $182.44 / $243.20 / $581.04	Professional	TC	$182.44	$243.20	$581.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.41 / $93.41 / $93.41	Facility	26	$93.41	$93.41	$93.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $261.51 / $524.22 / $1,007.67	Professional		$261.51	$524.22	$1,007.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.48 / $100.34 / $163.60	Professional	26	$59.48	$100.34	$163.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $188.46 / $380.42 / $804.96	Professional	TC	$188.46	$380.42	$804.96
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $318.45 / $422.58 / $1,484.52	Professional		$318.45	$422.58	$1,484.52
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $89.25 / $107.15 / $169.16	Professional	26	$89.25	$107.15	$169.16
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $218.36 / $271.83 / $387.18	Professional	TC	$218.36	$271.83	$387.18
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $310.58 / $310.58 / $310.58	Professional		$310.58	$310.58	$310.58
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $90.77 / $94.40 / $121.88	Professional	26	$90.77	$94.40	$121.88
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $114.24 / $165.06 / $412.02	Facility	26	$114.24	$165.06	$412.02
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $279.67 / $425.00 / $1,262.25	Professional		$279.67	$425.00	$1,262.25
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $82.78 / $126.00 / $225.04	Professional	26	$82.78	$126.00	$225.04
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $196.89 / $299.00 / $542.89	Professional	TC	$196.89	$299.00	$542.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $112.63 / $311.88 / $700.00	Professional		$112.63	$311.88	$700.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $56.88 / $93.41 / $93.41	Facility	26	$56.88	$93.41	$93.41
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $273.95 / $508.94 / $945.23	Professional		$273.95	$508.94	$945.23
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $62.26 / $100.03 / $167.62	Professional	26	$62.26	$100.03	$167.62
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $189.32 / $377.22 / $767.45	Professional	TC	$189.32	$377.22	$767.45
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $81.61 / $81.61 / $91.21	Facility	26	$81.61	$81.61	$91.21
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $265.99 / $270.02 / $573.50	Professional		$265.99	$270.02	$573.50
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $79.16 / $81.70 / $91.21	Professional	26	$79.16	$81.70	$91.21
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $184.30 / $188.42 / $482.29	Professional	TC	$184.30	$188.42	$482.29
United Facility/Professional Professional Modifier Low / Median / High Price $268.11 / $410.05 / $709.80	Professional		$268.11	$410.05	$709.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.47 / $96.67 / $163.30	Professional	26	$75.47	$96.67	$163.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $191.14 / $286.70 / $616.74	Professional	TC	$191.14	$286.70	$616.74