Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.45 / $59.09 / $146.83	Facility	26	$45.45	$59.09	$146.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.55 / $163.66 / $528.62	Professional		$67.55	$163.66	$528.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.34 / $61.45 / $213.54	Professional	26	$44.34	$61.45	$213.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.99 / $132.19 / $368.16	Professional	TC	$96.99	$132.19	$368.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.05 / $125.13 / $128.44	Professional		$97.05	$125.13	$128.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.65 / $48.63 / $73.41	Professional	26	$35.65	$48.63	$73.41
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $162.60 / $162.60 / $162.60	Professional	TC	$162.60	$162.60	$162.60
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $151.57 / $197.38 / $410.80	Professional		$151.57	$197.38	$410.80
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $47.00 / $76.17 / $127.01	Professional	26	$47.00	$76.17	$127.01
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $303.14 / $388.36 / $821.64	Professional	50	$303.14	$388.36	$821.64
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $104.57 / $144.38 / $314.16	Professional	TC	$104.57	$144.38	$314.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $54.02	Facility	26	$54.02	$54.02	$54.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.93 / $256.42 / $439.73	Professional		$139.93	$256.42	$439.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.71 / $59.86 / $94.86	Professional	26	$35.71	$59.86	$94.86
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $231.34 / $264.19 / $264.19	Professional	50	$231.34	$264.19	$264.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $99.74 / $186.52 / $331.61	Professional	TC	$99.74	$186.52	$331.61
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $182.78 / $242.45 / $621.14	Professional		$182.78	$242.45	$621.14
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.38 / $61.75 / $97.55	Professional	26	$51.38	$61.75	$97.55
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $125.17 / $155.79 / $221.87	Professional	TC	$125.17	$155.79	$221.87
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $180.97 / $199.07 / $214.53	Professional		$180.97	$199.07	$214.53
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.51 / $58.50 / $89.60	Professional	26	$52.51	$58.50	$89.60
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $173.61 / $206.80 / $208.33	Professional	TC	$173.61	$206.80	$208.33
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $45.45 / $66.95 / $155.80	Facility	26	$45.45	$66.95	$155.80
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $72.84 / $176.42 / $523.96	Professional		$72.84	$176.42	$523.96
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $45.45 / $66.95 / $152.00	Professional	26	$45.45	$66.95	$152.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $99.08 / $140.08 / $368.16	Professional	TC	$99.08	$140.08	$368.16
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $83.52 / $252.20 / $381.07	Professional		$83.52	$252.20	$381.07
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $35.84 / $54.02 / $54.02	Facility	26	$35.84	$54.02	$54.02
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $148.99 / $256.30 / $425.82	Professional		$148.99	$256.30	$425.82
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.90 / $59.86 / $96.76	Professional	26	$35.90	$59.86	$96.76
Priority Health Facility/Professional Professional Modifier 50 Low / Median / High Price $231.34 / $264.19 / $264.19	Professional	50	$231.34	$264.19	$264.19
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $104.65 / $181.17 / $331.61	Professional	TC	$104.65	$181.17	$331.61
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $46.50 / $46.50 / $58.00	Facility	26	$46.50	$46.50	$58.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $144.16 / $146.96 / $248.00	Professional		$144.16	$146.96	$248.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $45.37 / $46.50 / $58.00	Professional	26	$45.37	$46.50	$58.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $97.71 / $101.59 / $190.00	Professional	TC	$97.71	$101.59	$190.00
United Facility/Professional Professional Modifier Low / Median / High Price $155.18 / $217.09 / $359.12	Professional		$155.18	$217.09	$359.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.34 / $55.92 / $93.15	Professional	26	$44.34	$55.92	$93.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.88 / $146.50 / $249.74	Professional	TC	$109.88	$146.50	$249.74