Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.89 / $581.85 / $974.40	Facility		$107.89	$581.85	$974.40
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.75 / $22.00 / $45.65	Facility	26	$14.75	$22.00	$45.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.59 / $98.50 / $215.11	Professional		$81.59	$98.50	$215.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.16 / $15.03 / $72.01	Professional	26	$13.16	$15.03	$72.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.40 / $80.31 / $149.21	Professional	TC	$67.40	$80.31	$149.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.72 / $17.96 / $27.51	Professional	26	$11.72	$17.96	$27.51
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,000.00 / $8,639.91 / $79,506.39	Facility		$5,000.00	$8,639.91	$79,506.39
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $97.45 / $130.57 / $164.32	Professional		$97.45	$130.57	$164.32
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $15.44 / $25.03 / $38.88	Professional	26	$15.44	$25.03	$38.88
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $82.00 / $101.15 / $139.29	Professional	TC	$82.00	$101.15	$139.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $108.20 / $245.66 / $582.00	Facility		$108.20	$245.66	$582.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.75 / $17.75 / $17.75	Facility	26	$17.75	$17.75	$17.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.80 / $105.72 / $179.59	Professional		$73.80	$105.72	$179.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.74 / $19.57 / $30.46	Professional	26	$11.74	$19.57	$30.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.10 / $85.98 / $148.41	Professional	TC	$60.10	$85.98	$148.41
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $97.53 / $131.54 / $158.44	Professional		$97.53	$131.54	$158.44
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.86 / $20.30 / $32.10	Professional	26	$16.86	$20.30	$32.10
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $98.12 / $122.20 / $174.09	Professional	TC	$98.12	$122.20	$174.09
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $270.13 / $621.44 / $1,159.05	Facility		$270.13	$621.44	$1,159.05
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.89 / $19.52 / $169.65	Professional	26	$16.89	$19.52	$169.65
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $118.68 / $361.43 / $884.16	Facility		$118.68	$361.43	$884.16
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $14.75 / $23.51 / $47.20	Facility	26	$14.75	$23.51	$47.20
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $87.36 / $107.89 / $253.98	Professional		$87.36	$107.89	$253.98
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $13.62 / $19.89 / $58.26	Professional	26	$13.62	$19.89	$58.26
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $72.98 / $93.14 / $200.25	Professional	TC	$72.98	$93.14	$200.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $22.66 / $98.95 / $186.20	Professional		$22.66	$98.95	$186.20
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $102.04 / $222.94 / $740.67	Facility		$102.04	$222.94	$740.67
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $11.03 / $17.75 / $17.75	Facility	26	$11.03	$17.75	$17.75
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $74.50 / $105.72 / $171.63	Professional		$74.50	$105.72	$171.63
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.86 / $19.66 / $31.36	Professional	26	$11.86	$19.66	$31.36
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $61.77 / $85.98 / $141.47	Professional	TC	$61.77	$85.98	$141.47
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $89.22 / $100.32 / $100.32	Facility		$89.22	$100.32	$100.32
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $15.28 / $15.28 / $18.00	Facility	26	$15.28	$15.28	$18.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $89.22 / $100.32 / $109.44	Professional		$89.22	$100.32	$109.44
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $14.93 / $15.28 / $18.00	Professional	26	$14.93	$15.28	$18.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $71.22 / $85.04 / $93.62	Professional	TC	$71.22	$85.04	$93.62
United Facility/Professional Professional Modifier Low / Median / High Price $76.30 / $101.26 / $183.14	Professional		$76.30	$101.26	$183.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.68 / $18.26 / $30.83	Professional	26	$14.68	$18.26	$30.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.77 / $85.89 / $151.41	Professional	TC	$64.77	$85.89	$151.41