Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.47 / $139.26 / $244.33	Facility	26	$112.47	$139.26	$244.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $266.20 / $357.57 / $530.63	Professional		$266.20	$357.57	$530.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.37 / $121.89 / $345.97	Professional	26	$99.37	$121.89	$345.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $159.22 / $220.00 / $385.70	Professional	TC	$159.22	$220.00	$385.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $202.49 / $310.35 / $310.35	Professional		$202.49	$310.35	$310.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $85.05 / $115.29 / $175.44	Professional	26	$85.05	$115.29	$175.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $271.74 / $271.74 / $271.74	Professional	TC	$271.74	$271.74	$271.74
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $286.97 / $297.80 / $297.80	Professional		$286.97	$297.80	$297.80
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $112.16 / $181.20 / $279.51	Professional	26	$112.16	$181.20	$279.51
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $174.82 / $222.05 / $985.73	Professional	TC	$174.82	$222.05	$985.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.28 / $128.28 / $128.28	Facility	26	$128.28	$128.28	$128.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $344.62 / $620.76 / $1,062.74	Professional		$344.62	$620.76	$1,062.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.84 / $137.55 / $221.16	Professional	26	$80.84	$137.55	$221.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $248.07 / $460.08 / $825.88	Professional	TC	$248.07	$460.08	$825.88
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $343.63 / $455.08 / $1,527.48	Professional		$343.63	$455.08	$1,527.48
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $122.74 / $147.06 / $232.25	Professional	26	$122.74	$147.06	$232.25
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $209.18 / $260.51 / $371.12	Professional	TC	$209.18	$260.51	$371.12
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $484.06 / $521.54 / $522.12	Professional		$484.06	$521.54	$522.12
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $124.53 / $135.69 / $177.01	Professional	26	$124.53	$135.69	$177.01
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $107.12 / $155.32 / $366.49	Facility	26	$107.12	$155.32	$366.49
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $269.77 / $395.30 / $970.95	Professional		$269.77	$395.30	$970.95
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $107.12 / $142.84 / $335.16	Professional	26	$107.12	$142.84	$335.16
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $162.65 / $234.80 / $604.45	Professional	TC	$162.65	$234.80	$604.45
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $325.00 / $325.00 / $850.10	Professional		$325.00	$325.00	$850.10
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $78.84 / $128.28 / $128.28	Facility	26	$78.84	$128.28	$128.28
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $356.27 / $607.25 / $1,038.57	Professional		$356.27	$607.25	$1,038.57
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $84.12 / $134.44 / $228.43	Professional	26	$84.12	$134.44	$228.43
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $254.11 / $448.62 / $811.63	Professional	TC	$254.11	$448.62	$811.63
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $110.62 / $110.62 / $124.35	Facility	26	$110.62	$110.62	$124.35
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $275.20 / $279.18 / $679.00	Professional		$275.20	$279.18	$679.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $107.78 / $110.69 / $124.35	Professional	26	$107.78	$110.69	$124.35
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $164.52 / $171.39 / $554.65	Professional	TC	$164.52	$171.39	$554.65
United Facility/Professional Professional Modifier Low / Median / High Price $385.14 / $530.63 / $844.89	Professional		$385.14	$530.63	$844.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $103.63 / $130.71 / $219.24	Professional	26	$103.63	$130.71	$219.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $278.19 / $398.90 / $646.44	Professional	TC	$278.19	$398.90	$646.44