Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $120.51 / $126.82 / $398.16	Facility	26	$120.51	$126.82	$398.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.61 / $425.00 / $1,390.00	Professional		$346.61	$425.00	$1,390.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.20 / $126.00 / $389.19	Professional	26	$85.20	$126.00	$389.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $299.00 / $476.11	Professional	TC	$259.35	$299.00	$476.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.16 / $65.45 / $93.94	Professional	26	$64.16	$65.45	$93.94
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $330.29 / $437.08 / $712.00	Professional		$330.29	$437.08	$712.00
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $84.60 / $107.55 / $167.15	Professional	26	$84.60	$107.55	$167.15
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $245.69 / $327.45 / $561.22	Professional	TC	$245.69	$327.45	$561.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.55 / $96.55 / $96.55	Facility	26	$96.55	$96.55	$96.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $303.55 / $563.41 / $947.91	Professional		$303.55	$563.41	$947.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.14 / $103.95 / $172.11	Professional	26	$61.14	$103.95	$172.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $231.78 / $447.62 / $769.46	Professional	TC	$231.78	$447.62	$769.46
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $400.33 / $532.41 / $1,375.11	Professional		$400.33	$532.41	$1,375.11
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $92.64 / $110.99 / $175.16	Professional	26	$92.64	$110.99	$175.16
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $294.05 / $366.08 / $521.41	Professional	TC	$294.05	$366.08	$521.41
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.11 / $389.73 / $706.63	Professional		$123.11	$389.73	$706.63
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.78 / $99.49 / $138.94	Professional	26	$93.78	$99.49	$138.94
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $120.51 / $138.60 / $403.20	Facility	26	$120.51	$138.60	$403.20
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $348.34 / $463.96 / $1,390.00	Professional		$348.34	$463.96	$1,390.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $85.20 / $126.00 / $369.18	Professional	26	$85.20	$126.00	$369.18
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $263.14 / $322.17 / $729.56	Professional	TC	$263.14	$322.17	$729.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $89.66 / $320.60 / $700.00	Professional		$89.66	$320.60	$700.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $59.00 / $96.55 / $96.55	Facility	26	$59.00	$96.55	$96.55
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $311.58 / $557.32 / $918.38	Professional		$311.58	$557.32	$918.38
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.88 / $103.49 / $172.47	Professional	26	$63.88	$103.49	$172.47
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $237.80 / $413.11 / $765.04	Professional	TC	$237.80	$413.11	$765.04
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $83.99 / $83.99 / $91.00	Facility	26	$83.99	$83.99	$91.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $332.13 / $337.52 / $505.00	Professional		$332.13	$337.52	$505.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $81.79 / $84.07 / $91.00	Professional	26	$81.79	$84.07	$91.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $248.06 / $253.53 / $414.00	Professional	TC	$248.06	$253.53	$414.00
United Facility/Professional Professional Modifier Low / Median / High Price $334.68 / $452.22 / $773.54	Professional		$334.68	$452.22	$773.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.73 / $99.86 / $169.60	Professional	26	$73.73	$99.86	$169.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $240.89 / $345.21 / $590.26	Professional	TC	$240.89	$345.21	$590.26