Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.03 / $83.88 / $202.34	Facility	26	$64.03	$83.88	$202.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $179.49 / $232.42 / $491.23	Professional		$179.49	$232.42	$491.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.08 / $58.71 / $137.47	Professional	26	$51.08	$58.71	$137.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.72 / $175.12 / $388.52	Professional	TC	$131.72	$175.12	$388.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.91 / $132.60 / $147.34	Professional		$128.91	$132.60	$147.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.93 / $75.90 / $89.18	Professional	26	$43.93	$75.90	$89.18
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $191.85 / $199.09 / $485.10	Professional		$191.85	$199.09	$485.10
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $57.08 / $59.24 / $113.40	Professional	26	$57.08	$59.24	$113.40
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $134.77 / $139.85 / $371.74	Professional	TC	$134.77	$139.85	$371.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.64 / $65.64 / $65.64	Facility	26	$65.64	$65.64	$65.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.04 / $370.68 / $629.44	Professional		$190.04	$370.68	$629.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.89 / $70.01 / $115.95	Professional	26	$41.89	$70.01	$115.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $139.18 / $273.79 / $506.36	Professional	TC	$139.18	$273.79	$506.36
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $231.56 / $307.14 / $945.69	Professional		$231.56	$307.14	$945.69
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $62.38 / $74.95 / $118.47	Professional	26	$62.38	$74.95	$118.47
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $161.28 / $200.81 / $286.02	Professional	TC	$161.28	$200.81	$286.02
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $225.44 / $225.44 / $225.44	Professional		$225.44	$225.44	$225.44
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.77 / $69.29 / $151.63	Professional	26	$63.77	$69.29	$151.63
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $55.43 / $99.29 / $204.90	Facility	26	$55.43	$99.29	$204.90
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $185.99 / $257.01 / $655.25	Professional		$185.99	$257.01	$655.25
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $54.26 / $64.03 / $154.00	Professional	26	$54.26	$64.03	$154.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $134.56 / $189.31 / $549.58	Professional	TC	$134.56	$189.31	$549.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.61 / $198.18 / $404.50	Professional		$60.61	$198.18	$404.50
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $39.86 / $65.64 / $65.64	Facility	26	$39.86	$65.64	$65.64
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $191.31 / $364.14 / $613.58	Professional		$191.31	$364.14	$613.58
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.38 / $69.69 / $117.24	Professional	26	$43.38	$69.69	$117.24
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $139.85 / $273.79 / $505.16	Professional	TC	$139.85	$273.79	$505.16
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $56.78 / $56.78 / $65.50	Facility	26	$56.78	$56.78	$65.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $191.64 / $194.61 / $349.50	Professional		$191.64	$194.61	$349.50
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $55.34 / $56.79 / $65.50	Professional	26	$55.34	$56.79	$65.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $134.85 / $137.83 / $284.00	Professional	TC	$134.85	$137.83	$284.00
United Facility/Professional Professional Modifier Low / Median / High Price $202.19 / $303.29 / $492.05	Professional		$202.19	$303.29	$492.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.84 / $68.28 / $120.42	Professional	26	$53.84	$68.28	$120.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.30 / $212.77 / $392.35	Professional	TC	$147.30	$212.77	$392.35