Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.32 / $137.86 / $396.04	Facility	26	$125.32	$137.86	$396.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $203.67 / $249.67 / $380.51	Professional		$203.67	$249.67	$380.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.52 / $114.96 / $220.96	Professional	26	$87.52	$114.96	$220.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.29 / $119.70 / $220.00	Professional	TC	$97.29	$119.70	$220.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $309.97 / $309.97 / $309.97	Professional		$309.97	$309.97	$309.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $86.52 / $86.52 / $198.01	Professional	26	$86.52	$86.52	$198.01
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $218.64 / $226.89 / $859.54	Professional		$218.64	$226.89	$859.54
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $114.07 / $184.31 / $242.33	Professional	26	$114.07	$184.31	$242.33
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $104.57 / $108.52 / $634.20	Professional	TC	$104.57	$108.52	$634.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $129.66 / $129.66 / $129.66	Facility	26	$129.66	$129.66	$129.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $310.62 / $514.83 / $906.93	Professional		$310.62	$514.83	$906.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.23 / $134.51 / $222.85	Professional	26	$79.23	$134.51	$222.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $231.93 / $372.09 / $652.67	Professional	TC	$231.93	$372.09	$652.67
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $258.95 / $341.78 / $866.28	Professional		$258.95	$341.78	$866.28
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $125.02 / $149.90 / $236.32	Professional	26	$125.02	$149.90	$236.32
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $125.11 / $155.85 / $222.02	Professional	TC	$125.11	$155.85	$222.02
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $113.86 / $126.03 / $140.66	Professional	26	$113.86	$126.03	$140.66
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $125.32 / $164.18 / $409.83	Facility	26	$125.32	$164.18	$409.83
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $205.02 / $260.10 / $534.29	Professional		$205.02	$260.10	$534.29
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $106.37 / $125.33 / $267.00	Professional	26	$106.37	$125.33	$267.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $98.65 / $131.69 / $266.08	Professional	TC	$98.65	$131.69	$266.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $476.50 / $476.50 / $1,015.90	Professional		$476.50	$476.50	$1,015.90
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $129.66 / $129.66 / $129.66	Facility	26	$129.66	$129.66	$129.66
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $344.26 / $515.23 / $906.93	Professional		$344.26	$515.23	$906.93
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $80.45 / $134.41 / $224.62	Professional	26	$80.45	$134.41	$224.62
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $247.01 / $373.09 / $651.04	Professional	TC	$247.01	$373.09	$651.04
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $105.00 / $112.52 / $112.52	Facility	26	$105.00	$112.52	$112.52
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $209.94 / $212.10 / $549.50	Professional		$209.94	$212.10	$549.50
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $105.00 / $112.52 / $116.66	Professional	26	$105.00	$112.52	$116.66
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $97.40 / $101.57 / $444.50	Professional	TC	$97.40	$101.57	$444.50
United Facility/Professional Professional Modifier Low / Median / High Price $370.44 / $485.04 / $837.03	Professional		$370.44	$485.04	$837.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $102.44 / $132.26 / $221.94	Professional	26	$102.44	$132.26	$221.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $276.99 / $373.48 / $635.83	Professional	TC	$276.99	$373.48	$635.83