Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.19 / $62.88 / $158.60	Facility	26	$50.19	$62.88	$158.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.40 / $142.49 / $275.00	Professional		$115.40	$142.49	$275.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.26 / $48.07 / $127.53	Professional	26	$40.26	$48.07	$127.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $73.76 / $92.30 / $192.00	Professional	TC	$73.76	$92.30	$192.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.79 / $34.79 / $84.98	Professional	26	$34.79	$34.79	$84.98
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $128.94 / $133.82 / $260.56	Professional		$128.94	$133.82	$260.56
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $45.04 / $46.74 / $91.75	Professional	26	$45.04	$46.74	$91.75
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $83.91 / $87.08 / $168.80	Professional	TC	$83.91	$87.08	$168.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.84 / $51.84 / $51.84	Facility	26	$51.84	$51.84	$51.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.78 / $204.84 / $331.20	Professional		$113.78	$204.84	$331.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.83 / $56.01 / $91.88	Professional	26	$32.83	$56.01	$91.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.81 / $142.13 / $241.79	Professional	TC	$74.81	$142.13	$241.79
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $205.25 / $465.34	Professional		$154.88	$205.25	$465.34
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $49.20 / $58.94 / $93.28	Professional	26	$49.20	$58.94	$93.28
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $100.41 / $125.05 / $178.13	Professional	TC	$100.41	$125.05	$178.13
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.87 / $165.87 / $165.87	Professional		$165.87	$165.87	$165.87
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.26 / $55.29 / $84.36	Professional	26	$50.26	$55.29	$84.36
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $50.19 / $83.28 / $164.12	Facility	26	$50.19	$83.28	$164.12
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $117.32 / $161.27 / $311.12	Professional		$117.32	$161.27	$311.12
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $42.64 / $51.30 / $124.23	Professional	26	$42.64	$51.30	$124.23
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $73.76 / $103.82 / $197.52	Professional	TC	$73.76	$103.82	$197.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $76.90 / $240.26 / $325.89	Professional		$76.90	$240.26	$325.89
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $31.98 / $51.84 / $51.84	Facility	26	$31.98	$51.84	$51.84
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $121.65 / $202.33 / $331.20	Professional		$121.65	$202.33	$331.20
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.36 / $55.24 / $93.42	Professional	26	$34.36	$55.24	$93.42
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $79.16 / $136.38 / $235.26	Professional	TC	$79.16	$136.38	$235.26
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $44.85 / $44.85 / $53.00	Facility	26	$44.85	$44.85	$53.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $124.12 / $126.33 / $187.00	Professional		$124.12	$126.33	$187.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $43.63 / $44.95 / $53.00	Professional	26	$43.63	$44.95	$53.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $79.17 / $82.55 / $134.00	Professional	TC	$79.17	$82.55	$134.00
United Facility/Professional Professional Modifier Low / Median / High Price $125.92 / $168.01 / $271.49	Professional		$125.92	$168.01	$271.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.28 / $53.53 / $89.83	Professional	26	$42.28	$53.53	$89.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.18 / $113.59 / $187.69	Professional	TC	$82.18	$113.59	$187.69