Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.98 / $88.04 / $188.41	Facility	26	$66.98	$88.04	$188.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $226.44 / $322.33 / $1,321.00	Professional		$226.44	$322.33	$1,321.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.87 / $73.72 / $179.16	Professional	26	$58.87	$73.72	$179.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $159.22 / $220.00 / $604.45	Professional	TC	$159.22	$220.00	$604.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $161.63 / $195.19 / $206.42	Professional		$161.63	$195.19	$206.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $50.67 / $72.59 / $95.25	Professional	26	$50.67	$72.59	$95.25
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $162.37 / $162.37 / $162.37	Professional	TC	$162.37	$162.37	$162.37
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $240.61 / $249.69 / $870.23	Professional		$240.61	$249.69	$870.23
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $65.79 / $107.12 / $162.83	Professional	26	$65.79	$107.12	$162.83
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $174.82 / $271.36 / $707.36	Professional	TC	$174.82	$271.36	$707.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.64 / $75.64 / $75.64	Facility	26	$75.64	$75.64	$75.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $227.17 / $427.64 / $718.81	Professional		$227.17	$427.64	$718.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.25 / $81.05 / $132.12	Professional	26	$48.25	$81.05	$132.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $169.68 / $310.94 / $579.66	Professional	TC	$169.68	$310.94	$579.66
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $291.05 / $386.28 / $594.77	Professional		$291.05	$386.28	$594.77
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $71.95 / $86.43 / $136.51	Professional	26	$71.95	$86.43	$136.51
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $209.18 / $260.51 / $371.12	Professional	TC	$209.18	$260.51	$371.12
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $286.16 / $302.70 / $407.00	Professional		$286.16	$302.70	$407.00
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $73.52 / $79.87 / $100.69	Professional	26	$73.52	$79.87	$100.69
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $352.38 / $352.38 / $357.54	Professional	TC	$352.38	$352.38	$357.54
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $66.98 / $92.51 / $218.94	Facility	26	$66.98	$92.51	$218.94
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $226.45 / $342.75 / $1,139.00	Professional		$226.45	$342.75	$1,139.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $62.45 / $86.07 / $177.42	Professional	26	$62.45	$86.07	$177.42
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $162.65 / $240.00 / $597.13	Professional	TC	$162.65	$240.00	$597.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $68.09 / $245.10 / $476.45	Professional		$68.09	$245.10	$476.45
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $45.85 / $75.64 / $75.64	Facility	26	$45.85	$75.64	$75.64
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $410.05 / $709.73	Professional		$239.88	$410.05	$709.73
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.76 / $80.52 / $135.61	Professional	26	$50.76	$80.52	$135.61
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $177.81 / $299.77 / $578.03	Professional	TC	$177.81	$299.77	$578.03
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $65.40 / $65.40 / $75.00	Facility	26	$65.40	$65.40	$75.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $230.24 / $235.45 / $400.00	Professional		$230.24	$235.45	$400.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $63.74 / $65.42 / $75.00	Professional	26	$63.74	$65.42	$75.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $164.83 / $171.71 / $325.00	Professional	TC	$164.83	$171.71	$325.00
United Facility/Professional Professional Modifier Low / Median / High Price $241.85 / $339.96 / $558.23	Professional		$241.85	$339.96	$558.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.07 / $77.59 / $130.66	Professional	26	$62.07	$77.59	$130.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $178.36 / $257.63 / $451.68	Professional	TC	$178.36	$257.63	$451.68