Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.18 / $99.20 / $209.13	Facility	26	$66.18	$99.20	$209.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.90 / $190.47 / $243.49	Professional		$107.90	$190.47	$243.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.65 / $60.23 / $146.91	Professional	26	$49.65	$60.23	$146.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.66 / $70.70 / $188.44	Professional	TC	$49.66	$70.70	$188.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $96.70 / $96.70 / $96.70	Professional		$96.70	$96.70	$96.70
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.75 / $98.03 / $98.03	Professional	26	$53.75	$98.03	$98.03
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $123.10 / $200.82 / $900.56	Professional		$123.10	$200.82	$900.56
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $67.16 / $89.50 / $133.69	Professional	26	$67.16	$89.50	$133.69
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $55.94 / $93.20 / $798.85	Professional	TC	$55.94	$93.20	$798.85
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.09 / $77.09 / $77.09	Facility	26	$77.09	$77.09	$77.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.37 / $231.34 / $608.76	Professional		$102.37	$231.34	$608.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.14 / $72.68 / $119.57	Professional	26	$47.14	$72.68	$119.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.90 / $126.59 / $528.37	Professional	TC	$49.90	$126.59	$528.37
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $146.16 / $189.80 / $453.24	Professional		$146.16	$189.80	$453.24
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.23 / $87.30 / $137.06	Professional	26	$74.23	$87.30	$137.06
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $66.95 / $83.35 / $118.71	Professional	TC	$66.95	$83.35	$118.71
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.64 / $82.11 / $83.57	Professional	26	$74.64	$82.11	$83.57
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $66.18 / $104.03 / $211.78	Facility	26	$66.18	$104.03	$211.78
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $112.84 / $178.31 / $370.66	Professional		$112.84	$178.31	$370.66
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $52.85 / $68.66 / $146.91	Professional	26	$52.85	$68.66	$146.91
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $52.61 / $79.68 / $234.92	Professional	TC	$52.61	$79.68	$234.92
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $288.00 / $676.50 / $727.40	Professional		$288.00	$676.50	$727.40
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $37.82 / $77.09 / $77.09	Facility	26	$37.82	$77.09	$77.09
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $103.56 / $215.50 / $601.91	Professional		$103.56	$215.50	$601.91
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.00 / $72.68 / $119.57	Professional	26	$48.00	$72.68	$119.57
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $52.56 / $121.01 / $528.37	Professional	TC	$52.56	$121.01	$528.37
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $65.70 / $65.70 / $95.00	Facility	26	$65.70	$65.70	$95.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $119.87 / $122.60 / $524.85	Professional		$119.87	$122.60	$524.85
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $63.28 / $66.45 / $95.00	Professional	26	$63.28	$66.45	$95.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $55.68 / $56.90 / $429.85	Professional	TC	$55.68	$56.90	$429.85
United Facility/Professional Professional Modifier Low / Median / High Price $122.39 / $178.14 / $475.46	Professional		$122.39	$178.14	$475.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.91 / $72.09 / $130.47	Professional	26	$54.91	$72.09	$130.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.74 / $81.90 / $305.76	Professional	TC	$58.74	$81.90	$305.76