Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.40 / $103.72 / $241.92	Facility	26	$71.40	$103.72	$241.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $202.77 / $425.00 / $1,303.14	Professional		$202.77	$425.00	$1,303.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.48 / $126.00 / $322.00	Professional	26	$69.48	$126.00	$322.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.31 / $299.00 / $441.00	Professional	TC	$131.31	$299.00	$441.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $129.69 / $142.90 / $170.72	Professional		$129.69	$142.90	$170.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.19 / $70.94 / $113.56	Professional	26	$52.19	$70.94	$113.56
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $192.73 / $192.73 / $192.73	Professional	TC	$192.73	$192.73	$192.73
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $192.76 / $322.74 / $832.26	Professional		$192.76	$322.74	$832.26
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $68.80 / $112.52 / $169.48	Professional	26	$68.80	$112.52	$169.48
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $123.96 / $210.24 / $703.28	Professional	TC	$123.96	$210.24	$703.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.09 / $79.09 / $79.09	Facility	26	$79.09	$79.09	$79.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.95 / $418.65 / $817.97	Professional		$190.95	$418.65	$817.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.20 / $83.96 / $137.83	Professional	26	$50.20	$83.96	$137.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $128.63 / $306.70 / $646.05	Professional	TC	$128.63	$306.70	$646.05
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $231.55 / $306.88 / $1,217.57	Professional		$231.55	$306.88	$1,217.57
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $75.30 / $90.38 / $142.66	Professional	26	$75.30	$90.38	$142.66
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $148.36 / $184.70 / $263.08	Professional	TC	$148.36	$184.70	$263.08
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $214.18 / $248.32 / $640.89	Professional		$214.18	$248.32	$640.89
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $76.90 / $84.59 / $123.01	Professional	26	$76.90	$84.59	$123.01
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $69.88 / $101.32 / $249.47	Facility	26	$69.88	$101.32	$249.47
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $202.77 / $425.00 / $1,320.50	Professional		$202.77	$425.00	$1,320.50
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $69.87 / $126.00 / $319.83	Professional	26	$69.87	$126.00	$319.83
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $132.88 / $287.67 / $664.00	Professional	TC	$132.88	$287.67	$664.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $73.06 / $185.31 / $555.40	Professional		$73.06	$185.31	$555.40
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $47.74 / $79.09 / $79.09	Facility	26	$47.74	$79.09	$79.09
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $200.04 / $418.65 / $763.63	Professional		$200.04	$418.65	$763.63
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.70 / $83.78 / $140.93	Professional	26	$52.70	$83.78	$140.93
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $128.63 / $303.12 / $625.04	Professional	TC	$128.63	$303.12	$625.04
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $68.69 / $68.69 / $89.00	Facility	26	$68.69	$68.69	$89.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $193.93 / $197.03 / $511.50	Professional		$193.93	$197.03	$511.50
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $66.59 / $68.73 / $89.00	Professional	26	$66.59	$68.73	$89.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $125.58 / $128.35 / $422.50	Professional	TC	$125.58	$128.35	$422.50
United Facility/Professional Professional Modifier Low / Median / High Price $196.01 / $294.02 / $574.66	Professional		$196.01	$294.02	$574.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.14 / $81.78 / $136.01	Professional	26	$64.14	$81.78	$136.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $129.66 / $199.86 / $487.04	Professional	TC	$129.66	$199.86	$487.04