Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.62 / $133.25 / $249.47	Facility	26	$107.62	$133.25	$249.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.00 / $425.00 / $1,320.50	Professional		$234.00	$425.00	$1,320.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.50 / $140.00 / $473.51	Professional	26	$102.50	$140.00	$473.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $319.44 / $548.82	Professional	TC	$281.41	$319.44	$548.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $231.40 / $260.33 / $369.20	Professional		$231.40	$260.33	$369.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.16 / $135.16 / $222.61	Professional	26	$79.16	$135.16	$222.61
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $204.07 / $204.07 / $204.07	Professional	TC	$204.07	$204.07	$204.07
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $376.29 / $553.27 / $856.63	Professional		$376.29	$553.27	$856.63
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $102.31 / $131.01 / $201.15	Professional	26	$102.31	$131.01	$201.15
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $273.98 / $415.34 / $649.46	Professional	TC	$273.98	$415.34	$649.46
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.52 / $116.52 / $116.52	Facility	26	$116.52	$116.52	$116.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $354.73 / $723.45 / $1,362.00	Professional		$354.73	$723.45	$1,362.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.66 / $124.66 / $201.30	Professional	26	$73.66	$124.66	$201.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $258.47 / $553.96 / $1,143.15	Professional	TC	$258.47	$553.96	$1,143.15
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $455.53 / $605.29 / $2,147.00	Professional		$455.53	$605.29	$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 $327.83 / $408.31 / $581.67	Professional	TC	$327.83	$408.31	$581.67
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $446.37 / $491.01 / $893.48	Professional		$446.37	$491.01	$893.48
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $113.28 / $120.36 / $168.19	Professional	26	$113.28	$120.36	$168.19
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $510.78 / $519.62 / $1,002.94	Professional	TC	$510.78	$519.62	$1,002.94
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $102.50 / $145.74 / $374.22	Facility	26	$102.50	$145.74	$374.22
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $241.75 / $475.00 / $1,320.50	Professional		$241.75	$475.00	$1,320.50
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $102.50 / $145.15 / $369.18	Professional	26	$102.50	$145.15	$369.18
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $299.00 / $348.93 / $729.56	Professional	TC	$299.00	$348.93	$729.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $117.29 / $389.88 / $718.48	Professional		$117.29	$389.88	$718.48
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $70.73 / $116.52 / $116.52	Facility	26	$70.73	$116.52	$116.52
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $371.57 / $706.62 / $1,279.16	Professional		$371.57	$706.62	$1,279.16
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $76.65 / $123.97 / $201.30	Professional	26	$76.65	$123.97	$201.30
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $275.52 / $553.96 / $1,116.27	Professional	TC	$275.52	$553.96	$1,116.27
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $100.90 / $100.90 / $113.19	Facility	26	$100.90	$100.90	$113.19
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $382.06 / $388.26 / $1,036.00	Professional		$382.06	$388.26	$1,036.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $98.33 / $100.93 / $113.19	Professional	26	$98.33	$100.93	$113.19
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $281.13 / $287.36 / $922.81	Professional	TC	$281.13	$287.36	$922.81
United Facility/Professional Professional Modifier Low / Median / High Price $391.00 / $564.77 / $1,055.25	Professional		$391.00	$564.77	$1,055.25
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 $294.01 / $424.68 / $823.42	Professional	TC	$294.01	$424.68	$823.42