Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.17 / $129.33 / $289.39	Facility	26	$106.17	$129.33	$289.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $270.23 / $425.00 / $1,459.50	Professional		$270.23	$425.00	$1,459.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.82 / $140.00 / $322.00	Professional	26	$102.82	$140.00	$322.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $335.00 / $931.29	Professional	TC	$281.41	$335.00	$931.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $231.98 / $289.98 / $370.14	Professional		$231.98	$289.98	$370.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.61 / $110.11 / $148.41	Professional	26	$77.61	$110.11	$148.41
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $204.78 / $427.39 / $427.39	Professional	TC	$204.78	$427.39	$427.39
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $398.60 / $502.98 / $853.43	Professional		$398.60	$502.98	$853.43
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $108.10 / $131.01 / $201.15	Professional	26	$108.10	$131.01	$201.15
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $290.49 / $370.21 / $646.24	Professional	TC	$290.49	$370.21	$646.24
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.87 / $116.87 / $116.87	Facility	26	$116.87	$116.87	$116.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $353.10 / $723.45 / $1,364.05	Professional		$353.10	$723.45	$1,364.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.93 / $124.80 / $201.99	Professional	26	$73.93	$124.80	$201.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $259.37 / $554.21 / $1,143.63	Professional	TC	$259.37	$554.21	$1,143.63
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $456.71 / $606.88 / $2,147.00	Professional		$456.71	$606.88	$2,147.00
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 $328.96 / $409.74 / $583.70	Professional	TC	$328.96	$409.74	$583.70
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $448.24 / $493.07 / $893.48	Professional		$448.24	$493.07	$893.48
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $113.66 / $120.62 / $176.73	Professional	26	$113.66	$120.62	$176.73
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $521.96 / $521.96 / $521.96	Professional	TC	$521.96	$521.96	$521.96
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $102.82 / $145.74 / $374.22	Facility	26	$102.82	$145.74	$374.22
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $280.19 / $475.00 / $1,459.50	Professional		$280.19	$475.00	$1,459.50
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $102.82 / $142.38 / $322.00	Professional	26	$102.82	$142.38	$322.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $299.00 / $350.14 / $876.07	Professional	TC	$299.00	$350.14	$876.07
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $142.85 / $402.62 / $794.20	Professional		$142.85	$402.62	$794.20
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $70.73 / $116.87 / $116.87	Facility	26	$70.73	$116.87	$116.87
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $372.15 / $708.93 / $1,281.76	Professional		$372.15	$708.93	$1,281.76
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $76.92 / $124.66 / $201.99	Professional	26	$76.92	$124.66	$201.99
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $273.89 / $554.21 / $1,116.27	Professional	TC	$273.89	$554.21	$1,116.27
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $101.21 / $101.21 / $112.83	Facility	26	$101.21	$101.21	$112.83
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $383.29 / $389.52 / $1,036.00	Professional		$383.29	$389.52	$1,036.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $98.64 / $101.23 / $112.83	Professional	26	$98.64	$101.23	$112.83
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $282.06 / $288.31 / $923.17	Professional	TC	$282.06	$288.31	$923.17
United Facility/Professional Professional Modifier Low / Median / High Price $391.61 / $565.66 / $1,062.19	Professional		$391.61	$565.66	$1,062.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.75 / $118.54 / $201.80	Professional	26	$93.75	$118.54	$201.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $294.62 / $441.93 / $835.75	Professional	TC	$294.62	$441.93	$835.75