Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.17 / $138.60 / $289.39	Facility	26	$106.17	$138.60	$289.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $241.75 / $428.68 / $1,262.25	Professional		$241.75	$428.68	$1,262.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.82 / $140.00 / $434.22	Professional	26	$102.82	$140.00	$434.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $282.87 / $330.93 / $710.84	Professional	TC	$282.87	$330.93	$710.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $269.39 / $317.14 / $352.42	Professional		$269.39	$317.14	$352.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.61 / $83.40 / $157.11	Professional	26	$77.61	$83.40	$157.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $407.83 / $407.83 / $407.83	Professional	TC	$407.83	$407.83	$407.83
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $423.11 / $675.32 / $1,744.50	Professional		$423.11	$675.32	$1,744.50
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $108.10 / $165.27 / $250.65	Professional	26	$108.10	$165.27	$250.65
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $315.01 / $510.06 / $1,553.76	Professional	TC	$315.01	$510.06	$1,553.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.52 / $116.52 / $116.52	Facility	26	$116.52	$116.52	$116.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $376.17 / $758.65 / $1,397.91	Professional		$376.17	$758.65	$1,397.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.93 / $124.66 / $201.99	Professional	26	$73.93	$124.66	$201.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $281.26 / $594.75 / $1,160.02	Professional	TC	$281.26	$594.75	$1,160.02
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $485.50 / $645.54 / $2,213.21	Professional		$485.50	$645.54	$2,213.21
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $112.17 / $134.46 / $211.93	Professional	26	$112.17	$134.46	$211.93
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $356.77 / $444.28 / $632.85	Professional	TC	$356.77	$444.28	$632.85
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $472.13 / $480.97 / $594.16	Professional		$472.13	$480.97	$594.16
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $113.28 / $121.21 / $190.13	Professional	26	$113.28	$121.21	$190.13
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $102.81 / $147.03 / $374.22	Facility	26	$102.81	$147.03	$374.22
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $258.67 / $475.00 / $1,320.50	Professional		$258.67	$475.00	$1,320.50
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $102.82 / $145.15 / $339.00	Professional	26	$102.82	$145.15	$339.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $299.00 / $368.50 / $783.89	Professional	TC	$299.00	$368.50	$783.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $143.29 / $425.19 / $844.00	Professional		$143.29	$425.19	$844.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $70.73 / $116.52 / $116.52	Facility	26	$70.73	$116.52	$116.52
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $394.15 / $723.45 / $1,343.50	Professional		$394.15	$723.45	$1,343.50
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $76.92 / $124.41 / $201.99	Professional	26	$76.92	$124.41	$201.99
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $296.97 / $572.60 / $1,134.97	Professional	TC	$296.97	$572.60	$1,134.97
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $100.90 / $100.90 / $114.24	Facility	26	$100.90	$100.90	$114.24
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $405.55 / $412.28 / $953.28	Professional		$405.55	$412.28	$953.28
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $98.33 / $100.93 / $114.24	Professional	26	$98.33	$100.93	$114.24
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $304.62 / $311.39 / $839.04	Professional	TC	$304.62	$311.39	$839.04
United Facility/Professional Professional Modifier Low / Median / High Price $414.75 / $615.91 / $1,125.89	Professional		$414.75	$615.91	$1,125.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.26 / $118.54 / $198.82	Professional	26	$93.26	$118.54	$198.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $317.76 / $452.14 / $862.20	Professional	TC	$317.76	$452.14	$862.20