Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.41 / $123.48 / $256.51	Facility	26	$89.41	$123.48	$256.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $242.58 / $301.70 / $495.62	Professional		$242.58	$301.70	$495.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.45 / $95.56 / $271.99	Professional	26	$79.45	$95.56	$271.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $159.21 / $220.00 / $435.61	Professional	TC	$159.21	$220.00	$435.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $155.51 / $155.51 / $311.01	Professional		$155.51	$155.51	$311.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $69.02 / $74.92 / $209.46	Professional	26	$69.02	$74.92	$209.46
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $264.11 / $274.08 / $624.45	Professional		$264.11	$274.08	$624.45
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $89.29 / $92.66 / $176.98	Professional	26	$89.29	$92.66	$176.98
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $528.22 / $548.15 / $1,200.64	Professional	50	$528.22	$548.15	$1,200.64
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $174.82 / $181.41 / $460.93	Professional	TC	$174.82	$181.41	$460.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.96 / $101.96 / $101.96	Facility	26	$101.96	$101.96	$101.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $280.20 / $507.03 / $875.39	Professional		$280.20	$507.03	$875.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.31 / $108.82 / $181.02	Professional	26	$64.31	$108.82	$181.02
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $458.57 / $523.66 / $523.66	Professional	50	$458.57	$523.66	$523.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $203.92 / $371.49 / $712.78	Professional	TC	$203.92	$371.49	$712.78
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $317.81 / $421.68 / $1,235.72	Professional		$317.81	$421.68	$1,235.72
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.75 / $117.19 / $185.00	Professional	26	$97.75	$117.19	$185.00
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $209.23 / $260.45 / $370.96	Professional	TC	$209.23	$260.45	$370.96
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $373.38 / $373.38 / $373.38	Professional		$373.38	$373.38	$373.38
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $99.03 / $108.94 / $166.22	Professional	26	$99.03	$108.94	$166.22
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $217.86 / $217.87 / $820.26	Professional	50	$217.86	$217.87	$820.26
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $89.41 / $133.36 / $310.14	Facility	26	$89.41	$133.36	$310.14
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $244.24 / $346.33 / $896.07	Professional		$244.24	$346.33	$896.07
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $83.36 / $117.05 / $271.99	Professional	26	$83.36	$117.05	$271.99
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $162.63 / $234.77 / $647.67	Professional	TC	$162.63	$234.77	$647.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $94.81 / $320.95 / $618.23	Professional		$94.81	$320.95	$618.23
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $62.38 / $101.96 / $101.96	Facility	26	$62.38	$101.96	$101.96
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $299.23 / $500.40 / $875.39	Professional		$299.23	$500.40	$875.39
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.01 / $108.46 / $181.36	Professional	26	$67.01	$108.46	$181.36
Priority Health Facility/Professional Professional Modifier 50 Low / Median / High Price $458.57 / $523.66 / $523.66	Professional	50	$458.57	$523.66	$523.66
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $214.99 / $366.57 / $665.81	Professional	TC	$214.99	$366.57	$665.81
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $88.32 / $88.32 / $98.12	Facility	26	$88.32	$88.32	$98.12
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $252.95 / $257.68 / $351.55	Professional		$252.95	$257.68	$351.55
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $86.04 / $88.39 / $98.12	Professional	26	$86.04	$88.39	$98.12
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $164.57 / $171.53 / $253.43	Professional	TC	$164.57	$171.53	$253.43
United Facility/Professional Professional Modifier Low / Median / High Price $308.32 / $428.23 / $676.38	Professional		$308.32	$428.23	$676.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $84.48 / $105.46 / $178.35	Professional	26	$84.48	$105.46	$178.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $223.40 / $317.88 / $517.01	Professional	TC	$223.40	$317.88	$517.01