Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.82 / $44.35 / $92.63	Facility	26	$35.82	$44.35	$92.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.04 / $119.68 / $557.14	Professional		$101.04	$119.68	$557.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.76 / $41.87 / $110.33	Professional	26	$31.76	$41.87	$110.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.04 / $80.54 / $143.43	Professional	TC	$63.04	$80.54	$143.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.99 / $89.98 / $89.98	Professional		$62.99	$89.98	$89.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.52 / $35.79 / $72.14	Professional	26	$29.52	$35.79	$72.14
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $44.37 / $51.40 / $289.06	Professional	26	$44.37	$51.40	$289.06
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $117.06 / $154.06 / $202.63	Professional		$117.06	$154.06	$202.63
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $38.22 / $55.15 / $80.47	Professional	26	$38.22	$55.15	$80.47
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $78.81 / $92.84 / $138.41	Professional	TC	$78.81	$92.84	$138.41
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.57 / $43.57 / $43.57	Facility	26	$43.57	$43.57	$43.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.52 / $137.91 / $227.62	Professional		$91.52	$137.91	$227.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.98 / $42.21 / $70.13	Professional	26	$26.98	$42.21	$70.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.59 / $93.30 / $156.99	Professional	TC	$59.59	$93.30	$156.99
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $112.18 / $155.85 / $187.08	Professional		$112.18	$155.85	$187.08
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.91 / $50.30 / $79.27	Professional	26	$41.91	$50.30	$79.27
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $94.33 / $117.46 / $167.33	Professional	TC	$94.33	$117.46	$167.33
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $146.27 / $148.65 / $149.93	Professional		$146.27	$148.65	$149.93
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.11 / $44.22 / $64.73	Professional	26	$40.11	$44.22	$64.73
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $40.24 / $48.76 / $79.16	Professional	26	$40.24	$48.76	$79.16
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $35.42 / $48.79 / $110.33	Facility	26	$35.42	$48.79	$110.33
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $104.25 / $127.22 / $377.84	Professional		$104.25	$127.22	$377.84
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $33.21 / $51.64 / $97.85	Professional	26	$33.21	$51.64	$97.85
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $71.14 / $90.06 / $192.74	Professional	TC	$71.14	$90.06	$192.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $114.00 / $114.00 / $323.70	Professional		$114.00	$114.00	$323.70
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $22.69 / $43.57 / $43.57	Facility	26	$22.69	$43.57	$43.57
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $93.46 / $137.91 / $218.43	Professional		$93.46	$137.91	$218.43
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.04 / $42.43 / $70.13	Professional	26	$27.04	$42.43	$70.13
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $60.62 / $94.72 / $149.59	Professional	TC	$60.62	$94.72	$149.59
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $37.82 / $37.82 / $38.00	Facility	26	$37.82	$37.82	$38.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $101.00 / $120.02 / $129.72	Professional		$101.00	$120.02	$129.72
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $36.86 / $37.82 / $39.22	Professional	26	$36.86	$37.82	$39.22
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $63.00 / $82.19 / $90.48	Professional	TC	$63.00	$82.19	$90.48
United Facility/Professional Professional Modifier Low / Median / High Price $90.81 / $122.34 / $218.17	Professional		$90.81	$122.34	$218.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.13 / $43.36 / $75.59	Professional	26	$32.13	$43.36	$75.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.92 / $87.11 / $141.66	Professional	TC	$66.92	$87.11	$141.66