Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.16 / $77.84 / $159.69	Facility	26	$57.16	$77.84	$159.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.63 / $219.24 / $766.27	Professional		$130.63	$219.24	$766.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.28 / $62.94 / $181.00	Professional	26	$51.28	$62.94	$181.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.34 / $102.81 / $241.68	Professional	TC	$77.34	$102.81	$241.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $82.89 / $94.88 / $131.61	Professional		$82.89	$94.88	$131.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.52 / $53.43 / $99.34	Professional	26	$42.52	$53.43	$99.34
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $58.69 / $58.69 / $58.69	Professional	TC	$58.69	$58.69	$58.69
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $134.87 / $139.96 / $139.96	Professional		$134.87	$139.96	$139.96
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $56.05 / $91.34 / $138.04	Professional	26	$56.05	$91.34	$138.04
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $78.81 / $133.51 / $471.53	Professional	TC	$78.81	$133.51	$471.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.44 / $64.44 / $64.44	Facility	26	$64.44	$64.44	$64.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.24 / $248.78 / $443.65	Professional		$119.24	$248.78	$443.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.19 / $68.75 / $112.80	Professional	26	$41.19	$68.75	$112.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.26 / $152.77 / $306.29	Professional	TC	$70.26	$152.77	$306.29
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $161.12 / $212.94 / $650.54	Professional		$161.12	$212.94	$650.54
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.31 / $73.66 / $116.34	Professional	26	$61.31	$73.66	$116.34
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $94.33 / $117.46 / $167.33	Professional	TC	$94.33	$117.46	$167.33
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $157.54 / $163.83 / $182.07	Professional		$157.54	$163.83	$182.07
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.64 / $67.37 / $85.47	Professional	26	$62.64	$67.37	$85.47
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $148.05 / $148.05 / $148.05	Professional	TC	$148.05	$148.05	$148.05
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $57.16 / $79.84 / $198.89	Facility	26	$57.16	$79.84	$198.89
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $133.44 / $205.22 / $761.00	Professional		$133.44	$205.22	$761.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $53.43 / $74.03 / $162.87	Professional	26	$53.43	$74.03	$162.87
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $79.01 / $112.28 / $290.74	Professional	TC	$79.01	$112.28	$290.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $55.18 / $126.72 / $325.00	Professional		$55.18	$126.72	$325.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $64.44 / $64.44	Facility	26	$38.90	$64.44	$64.44
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $127.24 / $235.00 / $415.89	Professional		$127.24	$235.00	$415.89
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.40 / $68.59 / $115.15	Professional	26	$43.40	$68.59	$115.15
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $74.36 / $152.77 / $305.72	Professional	TC	$74.36	$152.77	$305.72
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $55.76 / $55.76 / $64.00	Facility	26	$55.76	$55.76	$64.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $134.54 / $136.69 / $280.50	Professional		$134.54	$136.69	$280.50
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $54.35 / $55.78 / $64.00	Professional	26	$54.35	$55.78	$64.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $79.17 / $80.93 / $216.50	Professional	TC	$79.17	$80.93	$216.50
United Facility/Professional Professional Modifier Low / Median / High Price $130.31 / $200.26 / $324.24	Professional		$130.31	$200.26	$324.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.12 / $63.94 / $110.87	Professional	26	$52.12	$63.94	$110.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.40 / $115.29 / $221.51	Professional	TC	$76.40	$115.29	$221.51