Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.31 / $126.00 / $241.92	Facility	26	$78.31	$126.00	$241.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $297.77 / $425.00 / $2,051.52	Professional		$297.77	$425.00	$2,051.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.31 / $126.00 / $276.00	Professional	26	$78.31	$126.00	$276.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $245.92 / $299.00 / $435.50	Professional	TC	$245.92	$299.00	$435.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $187.00 / $241.00 / $241.00	Professional		$187.00	$241.00	$241.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $59.17 / $67.40 / $144.97	Professional	26	$59.17	$67.40	$144.97
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $321.64 / $406.62 / $675.41	Professional		$321.64	$406.62	$675.41
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $81.19 / $98.32 / $151.99	Professional	26	$81.19	$98.32	$151.99
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $240.45 / $306.30 / $531.21	Professional	TC	$240.45	$306.30	$531.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.30 / $88.30 / $88.30	Facility	26	$88.30	$88.30	$88.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $285.02 / $562.21 / $979.98	Professional		$285.02	$562.21	$979.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.35 / $93.90 / $154.16	Professional	26	$56.35	$93.90	$154.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $214.69 / $426.77 / $776.42	Professional	TC	$214.69	$426.77	$776.42
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $369.01 / $490.19 / $1,416.80	Professional		$369.01	$490.19	$1,416.80
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $84.10 / $101.05 / $159.46	Professional	26	$84.10	$101.05	$159.46
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $272.33 / $339.13 / $483.08	Professional	TC	$272.33	$339.13	$483.08
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $358.94 / $377.18 / $726.40	Professional		$358.94	$377.18	$726.40
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.90 / $93.69 / $134.16	Professional	26	$85.90	$93.69	$134.16
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $431.84 / $431.84 / $431.84	Professional	TC	$431.84	$431.84	$431.84
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $78.31 / $115.24 / $374.22	Facility	26	$78.31	$115.24	$374.22
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $322.00 / $433.02 / $1,477.00	Professional		$322.00	$433.02	$1,477.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $78.31 / $126.00 / $269.64	Professional	26	$78.31	$126.00	$269.64
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $248.88 / $307.97 / $559.13	Professional	TC	$248.88	$307.97	$559.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $107.46 / $371.06 / $700.00	Professional		$107.46	$371.06	$700.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $53.01 / $88.30 / $88.30	Facility	26	$53.01	$88.30	$88.30
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $300.69 / $526.01 / $947.96	Professional		$300.69	$526.01	$947.96
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $59.17 / $93.87 / $157.59	Professional	26	$59.17	$93.87	$157.59
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $225.43 / $393.56 / $766.67	Professional	TC	$225.43	$393.56	$766.67
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $76.31 / $76.31 / $89.00	Facility	26	$76.31	$76.31	$89.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $309.14 / $314.38 / $589.00	Professional		$309.14	$314.38	$589.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $74.41 / $76.31 / $89.00	Professional	26	$74.41	$76.31	$89.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $232.82 / $238.06 / $500.00	Professional	TC	$232.82	$238.06	$500.00
United Facility/Professional Professional Modifier Low / Median / High Price $316.57 / $469.38 / $732.60	Professional		$316.57	$469.38	$732.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.52 / $87.69 / $151.69	Professional	26	$71.52	$87.69	$151.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $242.58 / $345.15 / $608.91	Professional	TC	$242.58	$345.15	$608.91