Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.18 / $70.95 / $155.41	Facility	26	$55.18	$70.95	$155.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.59 / $180.91 / $426.58	Professional		$114.59	$180.91	$426.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.07 / $63.03 / $255.77	Professional	26	$50.07	$63.03	$255.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $107.27 / $175.12 / $368.85	Professional	TC	$107.27	$175.12	$368.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $113.47 / $113.47 / $160.56	Professional		$113.47	$113.47	$160.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.13 / $63.64 / $103.22	Professional	26	$42.13	$63.64	$103.22
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $164.05 / $272.45 / $477.47	Professional		$164.05	$272.45	$477.47
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $54.71 / $89.16 / $134.72	Professional	26	$54.71	$89.16	$134.72
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $109.34 / $189.48 / $374.98	Professional	TC	$109.34	$189.48	$374.98
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 $154.76 / $302.73 / $501.95	Professional		$154.76	$302.73	$501.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.78 / $67.00 / $108.62	Professional	26	$39.78	$67.00	$108.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.98 / $215.29 / $396.58	Professional	TC	$112.98	$215.29	$396.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $197.45 / $261.77 / $744.62	Professional		$197.45	$261.77	$744.62
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 $130.87 / $162.90 / $232.01	Professional	TC	$130.87	$162.90	$232.01
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.91 / $200.11 / $222.43	Professional		$181.91	$200.11	$222.43
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.14 / $67.26 / $127.16	Professional	26	$61.14	$67.26	$127.16
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $55.18 / $77.93 / $180.01	Facility	26	$55.18	$77.93	$180.01
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $114.59 / $200.91 / $578.00	Professional		$114.59	$200.91	$578.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $52.56 / $77.23 / $202.51	Professional	26	$52.56	$77.23	$202.51
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $109.57 / $155.75 / $429.59	Professional	TC	$109.57	$155.75	$429.59
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.09 / $171.97 / $365.24	Professional		$58.09	$171.97	$365.24
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 $162.50 / $294.10 / $501.27	Professional		$162.50	$294.10	$501.27
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.24 / $66.86 / $111.76	Professional	26	$41.24	$66.86	$111.76
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $113.46 / $215.21 / $383.80	Professional	TC	$113.46	$215.21	$383.80
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 $163.96 / $166.34 / $289.00	Professional		$163.96	$166.34	$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 $109.51 / $111.91 / $227.00	Professional	TC	$109.51	$111.91	$227.00
United Facility/Professional Professional Modifier Low / Median / High Price $168.28 / $237.12 / $378.40	Professional		$168.28	$237.12	$378.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.42 / $65.11 / $107.46	Professional	26	$51.42	$65.11	$107.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $115.95 / $165.65 / $303.66	Professional	TC	$115.95	$165.65	$303.66