Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.86 / $67.93 / $155.41	Facility	26	$54.86	$67.93	$155.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $146.81 / $230.60 / $442.23	Professional		$146.81	$230.60	$442.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.07 / $58.83 / $202.51	Professional	26	$50.07	$58.83	$202.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.11 / $180.32 / $350.84	Professional	TC	$141.11	$180.32	$350.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $273.11 / $273.11 / $273.11	Professional		$273.11	$273.11	$273.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.50 / $56.53 / $90.14	Professional	26	$41.50	$56.53	$90.14
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $196.14 / $203.54 / $394.85	Professional		$196.14	$203.54	$394.85
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $54.71 / $56.77 / $108.76	Professional	26	$54.71	$56.77	$108.76
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $141.44 / $146.77 / $286.08	Professional	TC	$141.44	$146.77	$286.08
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 $174.16 / $311.25 / $523.03	Professional		$174.16	$311.25	$523.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.51 / $66.94 / $108.71	Professional	26	$39.51	$66.94	$108.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $126.82 / $235.08 / $408.81	Professional	TC	$126.82	$235.08	$408.81
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $237.19 / $314.86 / $741.04	Professional		$237.19	$314.86	$741.04
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 $169.27 / $210.76 / $300.20	Professional	TC	$169.27	$210.76	$300.20
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $230.94 / $255.00 / $255.00	Professional		$230.94	$255.00	$255.00
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.14 / $66.31 / $89.77	Professional	26	$61.14	$66.31	$89.77
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $266.25 / $266.25 / $266.25	Professional	TC	$266.25	$266.25	$266.25
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $52.25 / $77.93 / $178.85	Facility	26	$52.25	$77.93	$178.85
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $151.57 / $242.23 / $536.72	Professional		$151.57	$242.23	$536.72
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $51.61 / $70.80 / $176.07	Professional	26	$51.61	$70.80	$176.07
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $144.15 / $186.80 / $419.56	Professional	TC	$144.15	$186.80	$419.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $96.51 / $324.50 / $483.99	Professional		$96.51	$324.50	$483.99
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 $185.04 / $307.69 / $501.95	Professional		$185.04	$307.69	$501.95
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.97 / $66.86 / $111.76	Professional	26	$40.97	$66.86	$111.76
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $133.43 / $230.34 / $402.62	Professional	TC	$133.43	$230.34	$402.62
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 $197.95 / $201.11 / $289.00	Professional		$197.95	$201.11	$289.00
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 $143.50 / $146.68 / $227.00	Professional	TC	$143.50	$146.68	$227.00
United Facility/Professional Professional Modifier Low / Median / High Price $192.94 / $257.62 / $418.39	Professional		$192.94	$257.62	$418.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.58 / $65.11 / $107.39	Professional	26	$50.58	$65.11	$107.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $140.61 / $199.50 / $321.50	Professional	TC	$140.61	$199.50	$321.50