Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $121.47 / $127.36 / $398.16	Facility	26	$121.47	$127.36	$398.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $342.85 / $425.00 / $1,390.00	Professional		$342.85	$425.00	$1,390.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.12 / $119.21 / $145.65	Professional	26	$85.12	$119.21	$145.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $256.94 / $299.00 / $484.30	Professional	TC	$256.94	$299.00	$484.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $140.60 / $140.60 / $140.60	Professional	26	$140.60	$140.60	$140.60
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $379.81 / $379.81 / $379.81	Professional	50	$379.81	$379.81	$379.81
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $330.34 / $549.80 / $871.93	Professional		$330.34	$549.80	$871.93
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $85.28 / $138.16 / $211.79	Professional	26	$85.28	$138.16	$211.79
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $660.68 / $1,099.61 / $1,743.86	Professional	50	$660.68	$1,099.61	$1,743.86
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $245.05 / $411.66 / $710.76	Professional	TC	$245.05	$411.66	$710.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.37 / $97.37 / $97.37	Facility	26	$97.37	$97.37	$97.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $303.49 / $564.86 / $949.78	Professional		$303.49	$564.86	$949.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.34 / $105.16 / $173.86	Professional	26	$61.34	$105.16	$173.86
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $507.23 / $580.67 / $580.67	Professional	50	$507.23	$580.67	$580.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $231.18 / $447.62 / $771.72	Professional	TC	$231.18	$447.62	$771.72
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $400.29 / $532.29 / $1,378.57	Professional		$400.29	$532.29	$1,378.57
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $93.36 / $111.85 / $176.59	Professional	26	$93.36	$111.85	$176.59
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $293.29 / $365.14 / $520.05	Professional	TC	$293.29	$365.14	$520.05
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.69 / $103.99 / $134.63	Professional	26	$93.69	$103.99	$134.63
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $121.47 / $138.60 / $403.20	Facility	26	$121.47	$138.60	$403.20
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $346.44 / $442.53 / $1,390.00	Professional		$346.44	$442.53	$1,390.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $85.57 / $126.00 / $307.44	Professional	26	$85.57	$126.00	$307.44
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $260.87 / $319.35 / $729.56	Professional	TC	$260.87	$319.35	$729.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $97.34 / $346.77 / $700.00	Professional		$97.34	$346.77	$700.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $59.71 / $97.37 / $97.37	Facility	26	$59.71	$97.37	$97.37
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $311.64 / $557.32 / $920.21	Professional		$311.64	$557.32	$920.21
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $64.06 / $104.52 / $173.86	Professional	26	$64.06	$104.52	$173.86
Priority Health Facility/Professional Professional Modifier 50 Low / Median / High Price $507.23 / $580.67 / $616.05	Professional	50	$507.23	$580.67	$616.05
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $237.25 / $413.82 / $765.04	Professional	TC	$237.25	$413.82	$765.04
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $84.35 / $84.35 / $91.59	Facility	26	$84.35	$84.35	$91.59
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $330.34 / $335.66 / $504.00	Professional		$330.34	$335.66	$504.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $82.14 / $84.44 / $91.59	Professional	26	$82.14	$84.44	$91.59
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $245.90 / $251.32 / $412.41	Professional	TC	$245.90	$251.32	$412.41
United Facility/Professional Professional Modifier Low / Median / High Price $323.77 / $460.76 / $751.75	Professional		$323.77	$460.76	$751.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.34 / $100.66 / $170.96	Professional	26	$72.34	$100.66	$170.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $253.15 / $360.74 / $662.19	Professional	TC	$253.15	$360.74	$662.19