Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.09 / $113.60 / $284.68	Facility	26	$90.09	$113.60	$284.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.01 / $174.65 / $306.55	Professional		$137.01	$174.65	$306.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.82 / $81.34 / $138.49	Professional	26	$56.82	$81.34	$138.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.66 / $87.11 / $243.50	Professional	TC	$58.66	$87.11	$243.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $68.41 / $72.33 / $79.56	Professional	26	$68.41	$72.33	$79.56
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $159.69 / $258.69 / $915.39	Professional		$159.69	$258.69	$915.39
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $91.69 / $121.67 / $155.63	Professional	26	$91.69	$121.67	$155.63
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $68.02 / $111.32 / $798.85	Professional	TC	$68.02	$111.32	$798.85
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.26 / $105.26 / $105.26	Facility	26	$105.26	$105.26	$105.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $132.05 / $287.43 / $628.20	Professional		$132.05	$287.43	$628.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.78 / $88.36 / $163.75	Professional	26	$60.78	$88.36	$163.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.58 / $166.04 / $542.32	Professional	TC	$59.58	$166.04	$542.32
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $188.77 / $244.20 / $498.04	Professional		$188.77	$244.20	$498.04
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $100.89 / $119.58 / $188.28	Professional	26	$100.89	$119.58	$188.28
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $81.45 / $101.30 / $144.21	Professional	TC	$81.45	$101.30	$144.21
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $102.03 / $112.24 / $114.06	Professional	26	$102.03	$112.24	$114.06
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $90.09 / $122.00 / $294.58	Facility	26	$90.09	$122.00	$294.58
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $143.05 / $209.42 / $512.66	Professional		$143.05	$209.42	$512.66
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $59.11 / $90.09 / $167.96	Professional	26	$59.11	$90.09	$167.96
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $62.14 / $95.55 / $357.66	Professional	TC	$62.14	$95.55	$357.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $96.25 / $423.50 / $687.40	Professional		$96.25	$423.50	$687.40
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $43.33 / $105.26 / $105.26	Facility	26	$43.33	$105.26	$105.26
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $140.05 / $277.39 / $622.10	Professional		$140.05	$277.39	$622.10
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.56 / $87.72 / $159.85	Professional	26	$63.56	$87.72	$159.85
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $62.57 / $157.59 / $539.83	Professional	TC	$62.57	$157.59	$539.83
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $89.97 / $89.97 / $108.00	Facility	26	$89.97	$89.97	$108.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $154.56 / $157.93 / $537.85	Professional		$154.56	$157.93	$537.85
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $87.03 / $90.65 / $108.00	Professional	26	$87.03	$90.65	$108.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $66.55 / $67.95 / $429.85	Professional	TC	$66.55	$67.95	$429.85
United Facility/Professional Professional Modifier Low / Median / High Price $157.57 / $214.63 / $481.71	Professional		$157.57	$214.63	$481.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.20 / $97.80 / $180.30	Professional	26	$64.20	$97.80	$180.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.41 / $104.39 / $357.29	Professional	TC	$68.41	$104.39	$357.29