Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $126.00 / $174.07 / $374.22	Facility	26	$126.00	$174.07	$374.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $378.23 / $425.00 / $1,664.63	Professional		$378.23	$425.00	$1,664.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $119.21 / $145.65 / $386.40	Professional	26	$119.21	$145.65	$386.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $255.88 / $299.00 / $460.76	Professional	TC	$255.88	$299.00	$460.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $218.34 / $272.92 / $347.49	Professional		$218.34	$272.92	$347.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $94.21 / $172.92 / $201.33	Professional	26	$94.21	$172.92	$201.33
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $355.17 / $368.58 / $760.42	Professional		$355.17	$368.58	$760.42
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $122.20 / $126.81 / $238.63	Professional	26	$122.20	$126.81	$238.63
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $232.98 / $241.77 / $528.02	Professional	TC	$232.98	$241.77	$528.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $139.38 / $139.38 / $139.38	Facility	26	$139.38	$139.38	$139.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $322.95 / $628.92 / $1,101.41	Professional		$322.95	$628.92	$1,101.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.42 / $149.13 / $241.83	Professional	26	$86.42	$149.13	$241.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $220.56 / $445.92 / $819.00	Professional	TC	$220.56	$445.92	$819.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $427.02 / $565.85 / $1,478.01	Professional		$427.02	$565.85	$1,478.01
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $133.66 / $160.46 / $253.40	Professional	26	$133.66	$160.46	$253.40
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $278.79 / $347.19 / $494.56	Professional	TC	$278.79	$347.19	$494.56
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $420.49 / $701.42 / $729.59	Professional		$420.49	$701.42	$729.59
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $128.01 / $138.26 / $217.91	Professional	26	$128.01	$138.26	$217.91
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $126.00 / $182.06 / $403.20	Facility	26	$126.00	$182.06	$403.20
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $381.89 / $475.00 / $1,531.93	Professional		$381.89	$475.00	$1,531.93
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $122.94 / $171.65 / $380.52	Professional	26	$122.94	$171.65	$380.52
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $258.94 / $311.17 / $729.56	Professional	TC	$258.94	$311.17	$729.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $205.01 / $654.16 / $916.80	Professional		$205.01	$654.16	$916.80
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $139.38 / $139.38 / $139.38	Facility	26	$139.38	$139.38	$139.38
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $335.87 / $595.51 / $1,100.75	Professional		$335.87	$595.51	$1,100.75
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $88.32 / $149.13 / $246.17	Professional	26	$88.32	$149.13	$246.17
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $230.78 / $421.37 / $807.51	Professional	TC	$230.78	$421.37	$807.51
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $120.57 / $120.57 / $141.50	Facility	26	$120.57	$120.57	$141.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $360.12 / $365.58 / $657.07	Professional		$360.12	$365.58	$657.07
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $117.61 / $120.57 / $141.50	Professional	26	$117.61	$120.57	$141.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $239.62 / $245.01 / $515.57	Professional	TC	$239.62	$245.01	$515.57
United Facility/Professional Professional Modifier Low / Median / High Price $365.14 / $547.71 / $952.88	Professional		$365.14	$547.71	$952.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $110.54 / $140.87 / $239.82	Professional	26	$110.54	$140.87	$239.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $249.89 / $355.56 / $654.35	Professional	TC	$249.89	$355.56	$654.35