Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.58 / $157.02 / $403.20	Facility	26	$117.58	$157.02	$403.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $347.69 / $425.00 / $1,754.00	Professional		$347.69	$425.00	$1,754.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.20 / $126.00 / $254.90	Professional	26	$85.20	$126.00	$254.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $299.00 / $478.28	Professional	TC	$259.35	$299.00	$478.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.40 / $64.40 / $64.40	Professional	26	$64.40	$64.40	$64.40
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $331.88 / $553.89 / $869.98	Professional		$331.88	$553.89	$869.98
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $84.92 / $137.57 / $209.24	Professional	26	$84.92	$137.57	$209.24
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $246.96 / $416.31 / $710.76	Professional	TC	$246.96	$416.31	$710.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.55 / $96.55 / $96.55	Facility	26	$96.55	$96.55	$96.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.73 / $563.41 / $949.22	Professional		$302.73	$563.41	$949.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.14 / $103.96 / $167.31	Professional	26	$61.14	$103.96	$167.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $232.98 / $457.74 / $771.15	Professional	TC	$232.98	$457.74	$771.15
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $402.30 / $535.04 / $1,375.11	Professional		$402.30	$535.04	$1,375.11
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $93.02 / $111.46 / $175.85	Professional	26	$93.02	$111.46	$175.85
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $295.57 / $367.98 / $524.11	Professional	TC	$295.57	$367.98	$524.11
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $391.23 / $677.92 / $705.15	Professional		$391.23	$677.92	$705.15
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.78 / $103.13 / $139.50	Professional	26	$93.78	$103.13	$139.50
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $117.58 / $165.06 / $412.02	Facility	26	$117.58	$165.06	$412.02
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $347.69 / $475.00 / $1,477.00	Professional		$347.69	$475.00	$1,477.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $85.20 / $126.00 / $322.00	Professional	26	$85.20	$126.00	$322.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $262.49 / $330.83 / $876.07	Professional	TC	$262.49	$330.83	$876.07
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $102.72 / $349.47 / $760.10	Professional		$102.72	$349.47	$760.10
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $59.00 / $96.55 / $96.55	Facility	26	$59.00	$96.55	$96.55
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $313.08 / $563.09 / $922.71	Professional		$313.08	$563.09	$922.71
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.88 / $103.09 / $171.82	Professional	26	$63.88	$103.09	$171.82
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $236.98 / $424.92 / $765.04	Professional	TC	$236.98	$424.92	$765.04
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $83.99 / $83.99 / $100.95	Facility	26	$83.99	$83.99	$100.95
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $332.75 / $338.15 / $541.90	Professional		$332.75	$338.15	$541.90
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $81.79 / $84.07 / $100.95	Professional	26	$81.79	$84.07	$100.95
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $248.68 / $254.16 / $440.95	Professional	TC	$248.68	$254.16	$440.95
United Facility/Professional Professional Modifier Low / Median / High Price $333.14 / $452.09 / $733.34	Professional		$333.14	$452.09	$733.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.31 / $100.05 / $169.89	Professional	26	$72.31	$100.05	$169.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $232.98 / $357.49 / $618.54	Professional	TC	$232.98	$357.49	$618.54