Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.09 / $116.70 / $270.56	Facility	26	$91.09	$116.70	$270.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.99 / $268.45 / $797.32	Professional		$215.99	$268.45	$797.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.00 / $86.40 / $251.00	Professional	26	$73.00	$86.40	$251.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.65 / $183.45 / $259.95	Professional	TC	$138.65	$183.45	$259.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $62.14 / $69.31 / $95.33	Professional	26	$62.14	$69.31	$95.33
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $224.95 / $370.40 / $638.30	Professional		$224.95	$370.40	$638.30
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $81.93 / $133.27 / $185.83	Professional	26	$81.93	$133.27	$185.83
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $143.03 / $237.13 / $466.55	Professional	TC	$143.03	$237.13	$466.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.84 / $93.84 / $93.84	Facility	26	$93.84	$93.84	$93.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $183.32 / $316.13 / $498.86	Professional		$183.32	$316.13	$498.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.46 / $99.88 / $163.28	Professional	26	$58.46	$99.88	$163.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $124.24 / $212.76 / $342.77	Professional	TC	$124.24	$212.76	$342.77
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $269.95 / $333.74 / $555.19	Professional		$269.95	$333.74	$555.19
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $89.53 / $107.59 / $170.06	Professional	26	$89.53	$107.59	$170.06
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $171.22 / $213.08 / $303.45	Professional	TC	$171.22	$213.08	$303.45
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.83 / $288.83 / $288.83	Professional		$288.83	$288.83	$288.83
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $86.17 / $92.68 / $107.05	Professional	26	$86.17	$92.68	$107.05
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $91.09 / $122.85 / $291.52	Facility	26	$91.09	$122.85	$291.52
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $220.64 / $294.05 / $797.32	Professional		$220.64	$294.05	$797.32
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $77.15 / $98.00 / $251.00	Professional	26	$77.15	$98.00	$251.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $141.63 / $191.62 / $410.85	Professional	TC	$141.63	$191.62	$410.85
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $87.00 / $231.96 / $414.05	Professional		$87.00	$231.96	$414.05
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $93.84 / $93.84 / $93.84	Facility	26	$93.84	$93.84	$93.84
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $198.22 / $317.27 / $502.15	Professional		$198.22	$317.27	$502.15
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $59.74 / $98.54 / $163.79	Professional	26	$59.74	$98.54	$163.79
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $126.92 / $214.27 / $347.40	Professional	TC	$126.92	$214.27	$347.40
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $77.81 / $81.36 / $81.36	Facility	26	$77.81	$81.36	$81.36
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $223.10 / $226.13 / $243.69	Professional		$223.10	$226.13	$243.69
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $77.81 / $81.36 / $84.30	Professional	26	$77.81	$81.36	$84.30
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $141.75 / $144.77 / $159.38	Professional	TC	$141.75	$144.77	$159.38
United Facility/Professional Professional Modifier Low / Median / High Price $217.00 / $279.61 / $463.81	Professional		$217.00	$279.61	$463.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.45 / $96.68 / $161.21	Professional	26	$75.45	$96.68	$161.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.49 / $190.81 / $320.50	Professional	TC	$138.49	$190.81	$320.50