Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.73 / $126.00 / $241.92	Facility	26	$79.73	$126.00	$241.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $322.69 / $425.00 / $1,828.85	Professional		$322.69	$425.00	$1,828.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.31 / $126.00 / $374.22	Professional	26	$78.31	$126.00	$374.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $244.10 / $299.00 / $453.21	Professional	TC	$244.10	$299.00	$453.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $187.97 / $187.97 / $269.30	Professional		$187.97	$187.97	$269.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $59.17 / $84.88 / $144.97	Professional	26	$59.17	$84.88	$144.97
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $356.27 / $356.27 / $356.27	Professional	TC	$356.27	$356.27	$356.27
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $306.00 / $407.04 / $675.41	Professional		$306.00	$407.04	$675.41
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $76.84 / $98.32 / $151.99	Professional	26	$76.84	$98.32	$151.99
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $229.16 / $307.12 / $537.60	Professional	TC	$229.16	$307.12	$537.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.95 / $87.95 / $87.95	Facility	26	$87.95	$87.95	$87.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $287.61 / $562.50 / $996.28	Professional		$287.61	$562.50	$996.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.35 / $94.23 / $154.50	Professional	26	$56.35	$94.23	$154.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $216.19 / $433.66 / $778.52	Professional	TC	$216.19	$433.66	$778.52
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $370.98 / $492.83 / $1,424.85	Professional		$370.98	$492.83	$1,424.85
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 $274.24 / $341.50 / $486.44	Professional	TC	$274.24	$341.50	$486.44
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $363.10 / $396.93 / $712.10	Professional		$363.10	$396.93	$712.10
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.52 / $94.14 / $126.14	Professional	26	$85.52	$94.14	$126.14
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $427.23 / $433.01 / $433.01	Professional	TC	$427.23	$433.01	$433.01
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 $327.85 / $437.75 / $1,459.50	Professional		$327.85	$437.75	$1,459.50
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $78.31 / $126.00 / $307.44	Professional	26	$78.31	$126.00	$307.44
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $249.53 / $307.97 / $686.82	Professional	TC	$249.53	$307.97	$686.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $88.80 / $330.27 / $700.00	Professional		$88.80	$330.27	$700.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $53.01 / $87.95 / $87.95	Facility	26	$53.01	$87.95	$87.95
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $301.27 / $531.45 / $957.81	Professional		$301.27	$531.45	$957.81
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $59.17 / $93.87 / $158.03	Professional	26	$59.17	$93.87	$158.03
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $227.34 / $397.77 / $775.89	Professional	TC	$227.34	$397.77	$775.89
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 $309.45 / $314.70 / $589.00	Professional		$309.45	$314.70	$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 $233.13 / $238.37 / $500.00	Professional	TC	$233.13	$238.37	$500.00
United Facility/Professional Professional Modifier Low / Median / High Price $317.18 / $458.15 / $707.70	Professional		$317.18	$458.15	$707.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.17 / $90.99 / $153.94	Professional	26	$71.17	$90.99	$153.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $243.19 / $342.42 / $636.80	Professional	TC	$243.19	$342.42	$636.80