Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.24 / $150.80 / $403.20	Facility	26	$114.24	$150.80	$403.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $311.63 / $425.00 / $549.21	Professional		$311.63	$425.00	$549.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.78 / $124.36 / $208.45	Professional	26	$82.78	$124.36	$208.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $226.44 / $299.00 / $377.53	Professional	TC	$226.44	$299.00	$377.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $182.18 / $227.73 / $299.52	Professional		$182.18	$227.73	$299.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.89 / $62.89 / $75.03	Professional	26	$62.89	$62.89	$75.03
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $296.42 / $307.60 / $800.39	Professional		$296.42	$307.60	$800.39
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $81.56 / $84.63 / $161.85	Professional	26	$81.56	$84.63	$161.85
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $214.86 / $286.77 / $657.74	Professional	TC	$214.86	$286.77	$657.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.41 / $93.41 / $93.41	Facility	26	$93.41	$93.41	$93.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $293.70 / $580.94 / $1,028.94	Professional		$293.70	$580.94	$1,028.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.48 / $100.17 / $162.74	Professional	26	$59.48	$100.17	$162.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $221.86 / $429.44 / $886.95	Professional	TC	$221.86	$429.44	$886.95
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $358.60 / $476.19 / $1,570.39	Professional		$358.60	$476.19	$1,570.39
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $89.25 / $107.15 / $169.16	Professional	26	$89.25	$107.15	$169.16
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $257.13 / $320.18 / $456.06	Professional	TC	$257.13	$320.18	$456.06
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $349.97 / $349.97 / $349.97	Professional		$349.97	$349.97	$349.97
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.48 / $93.69 / $97.58	Professional	26	$85.48	$93.69	$97.58
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $114.24 / $191.52 / $412.02	Facility	26	$114.24	$191.52	$412.02
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $314.44 / $425.00 / $1,192.00	Professional		$314.44	$425.00	$1,192.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $82.78 / $126.00 / $225.04	Professional	26	$82.78	$126.00	$225.04
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $231.66 / $299.00 / $639.86	Professional	TC	$231.66	$299.00	$639.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $86.60 / $304.05 / $700.00	Professional		$86.60	$304.05	$700.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $56.88 / $93.41 / $93.41	Facility	26	$56.88	$93.41	$93.41
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $300.72 / $568.60 / $1,028.94	Professional		$300.72	$568.60	$1,028.94
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $62.26 / $100.03 / $162.74	Professional	26	$62.26	$100.03	$162.74
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $222.97 / $428.48 / $842.46	Professional	TC	$222.97	$428.48	$842.46
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $81.30 / $81.30 / $91.21	Facility	26	$81.30	$81.30	$91.21
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $299.47 / $304.16 / $589.50	Professional		$299.47	$304.16	$589.50
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $79.16 / $81.39 / $91.21	Professional	26	$79.16	$81.39	$91.21
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $218.09 / $222.86 / $498.29	Professional	TC	$218.09	$222.86	$498.29
United Facility/Professional Professional Modifier Low / Median / High Price $303.70 / $454.13 / $787.03	Professional		$303.70	$454.13	$787.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.87 / $95.92 / $161.41	Professional	26	$75.87	$95.92	$161.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $222.97 / $327.08 / $652.21	Professional	TC	$222.97	$327.08	$652.21