Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.37 / $118.50 / $241.92	Facility	26	$68.37	$118.50	$241.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $425.00 / $1,908.74	Professional		$250.00	$425.00	$1,908.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.12 / $126.00 / $322.00	Professional	26	$65.12	$126.00	$322.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $220.61 / $299.00 / $561.04	Professional	TC	$220.61	$299.00	$561.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $197.87 / $226.14 / $264.11	Professional		$197.87	$226.14	$264.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.61 / $58.94 / $98.41	Professional	26	$48.61	$58.94	$98.41
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $294.52 / $407.33 / $819.35	Professional		$294.52	$407.33	$819.35
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $64.09 / $104.36 / $156.72	Professional	26	$64.09	$104.36	$156.72
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $230.43 / $315.26 / $700.08	Professional	TC	$230.43	$315.26	$700.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.64 / $73.64 / $73.64	Facility	26	$73.64	$73.64	$73.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $274.35 / $517.13 / $897.64	Professional		$274.35	$517.13	$897.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.85 / $78.04 / $129.00	Professional	26	$46.85	$78.04	$129.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $217.39 / $414.98 / $740.23	Professional	TC	$217.39	$414.98	$740.23
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $358.12 / $476.24 / $1,302.07	Professional		$358.12	$476.24	$1,302.07
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $70.16 / $84.28 / $132.97	Professional	26	$70.16	$84.28	$132.97
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $275.75 / $343.39 / $489.15	Professional	TC	$275.75	$343.39	$489.15
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $332.26 / $382.73 / $591.04	Professional		$332.26	$382.73	$591.04
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.64 / $78.81 / $111.76	Professional	26	$71.64	$78.81	$111.76
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $407.96 / $436.52 / $436.52	Professional	TC	$407.96	$436.52	$436.52
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $68.37 / $96.20 / $374.22	Facility	26	$68.37	$96.20	$374.22
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $277.85 / $425.00 / $1,731.23	Professional		$277.85	$425.00	$1,731.23
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $65.12 / $122.54 / $307.44	Professional	26	$65.12	$122.54	$307.44
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $220.61 / $308.69 / $729.56	Professional	TC	$220.61	$308.69	$729.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $89.48 / $331.19 / $700.00	Professional		$89.48	$331.19	$700.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $44.19 / $73.64 / $73.64	Facility	26	$44.19	$73.64	$73.64
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $288.16 / $499.76 / $858.98	Professional		$288.16	$499.76	$858.98
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $49.01 / $77.87 / $129.94	Professional	26	$49.01	$77.87	$129.94
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $228.26 / $386.78 / $735.50	Professional	TC	$228.26	$386.78	$735.50
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $63.71 / $63.71 / $89.00	Facility	26	$63.71	$63.71	$89.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $277.17 / $284.33 / $506.00	Professional		$277.17	$284.33	$506.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $62.09 / $63.72 / $89.00	Professional	26	$62.09	$63.72	$89.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $213.45 / $222.24 / $417.00	Professional	TC	$213.45	$222.24	$417.00
United Facility/Professional Professional Modifier Low / Median / High Price $305.04 / $430.04 / $669.17	Professional		$305.04	$430.04	$669.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.34 / $72.59 / $125.56	Professional	26	$60.34	$72.59	$125.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $243.79 / $327.67 / $605.41	Professional	TC	$243.79	$327.67	$605.41