Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.90 / $73.70 / $132.66	Facility	26	$60.90	$73.70	$132.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $220.66 / $291.38 / $1,144.00	Professional		$220.66	$291.38	$1,144.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.86 / $67.01 / $180.64	Professional	26	$54.86	$67.01	$180.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $159.25 / $213.65 / $436.02	Professional	TC	$159.25	$213.65	$436.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $139.06 / $152.10 / $222.11	Professional		$139.06	$152.10	$222.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.56 / $79.65 / $93.88	Professional	26	$45.56	$79.65	$93.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $154.38 / $154.38 / $154.38	Professional	TC	$154.38	$154.38	$154.38
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $226.30 / $234.84 / $234.84	Professional		$226.30	$234.84	$234.84
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $60.07 / $97.84 / $148.91	Professional	26	$60.07	$97.84	$148.91
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $166.23 / $260.08 / $569.27	Professional	TC	$166.23	$260.08	$569.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.05 / $69.05 / $69.05	Facility	26	$69.05	$69.05	$69.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $202.17 / $352.31 / $590.29	Professional		$202.17	$352.31	$590.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.88 / $73.81 / $120.10	Professional	26	$43.88	$73.81	$120.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $149.69 / $267.33 / $458.89	Professional	TC	$149.69	$267.33	$458.89
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $274.01 / $363.93 / $838.16	Professional		$274.01	$363.93	$838.16
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $65.76 / $78.94 / $124.56	Professional	26	$65.76	$78.94	$124.56
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $198.91 / $247.73 / $352.88	Professional	TC	$198.91	$247.73	$352.88
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $267.98 / $293.31 / $347.91	Professional		$267.98	$293.31	$347.91
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $67.14 / $71.94 / $91.76	Professional	26	$67.14	$71.94	$91.76
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $262.83 / $262.83 / $315.39	Professional	TC	$262.83	$262.83	$315.39
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $60.90 / $84.10 / $199.01	Facility	26	$60.90	$84.10	$199.01
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $220.67 / $303.77 / $1,095.00	Professional		$220.67	$303.77	$1,095.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $57.91 / $78.77 / $171.37	Professional	26	$57.91	$78.77	$171.37
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $162.66 / $220.00 / $451.72	Professional	TC	$162.66	$220.00	$451.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $62.33 / $218.32 / $419.90	Professional		$62.33	$218.32	$419.90
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $41.83 / $69.05 / $69.05	Facility	26	$41.83	$69.05	$69.05
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $213.49 / $344.65 / $563.32	Professional		$213.49	$344.65	$563.32
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.07 / $73.12 / $122.92	Professional	26	$46.07	$73.12	$122.92
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $155.36 / $258.77 / $451.08	Professional	TC	$155.36	$258.77	$451.08
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $59.73 / $59.73 / $68.00	Facility	26	$59.73	$59.73	$68.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $224.29 / $229.89 / $330.50	Professional		$224.29	$229.89	$330.50
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $58.18 / $59.77 / $68.00	Professional	26	$58.18	$59.77	$68.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $164.52 / $171.54 / $262.50	Professional	TC	$164.52	$171.54	$262.50
United Facility/Professional Professional Modifier Low / Median / High Price $214.47 / $289.00 / $496.33	Professional		$214.47	$289.00	$496.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.80 / $71.84 / $120.11	Professional	26	$55.80	$71.84	$120.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $156.74 / $223.03 / $410.47	Professional	TC	$156.74	$223.03	$410.47