Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.93 / $66.72 / $166.54	Facility	26	$50.93	$66.72	$166.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.72 / $203.65 / $363.48	Professional		$175.72	$203.65	$363.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.85 / $50.23 / $125.95	Professional	26	$43.85	$50.23	$125.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $131.54 / $155.30 / $228.60	Professional	TC	$131.54	$155.30	$228.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.13 / $96.03 / $135.28	Professional		$60.13	$96.03	$135.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.09 / $47.85 / $73.61	Professional	26	$40.09	$47.85	$73.61
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $195.68 / $284.30 / $424.20	Professional		$195.68	$284.30	$424.20
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $52.01 / $70.05 / $104.52	Professional	26	$52.01	$70.05	$104.52
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $143.66 / $214.25 / $319.68	Professional	TC	$143.66	$214.25	$319.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.80 / $59.80 / $59.80	Facility	26	$59.80	$59.80	$59.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.18 / $276.89 / $465.56	Professional		$166.18	$276.89	$465.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.15 / $63.96 / $103.32	Professional	26	$38.15	$63.96	$103.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $128.02 / $204.32 / $333.62	Professional	TC	$128.02	$204.32	$333.62
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $236.93 / $293.00 / $510.91	Professional		$236.93	$293.00	$510.91
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.93 / $68.36 / $107.89	Professional	26	$56.93	$68.36	$107.89
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $171.92 / $214.08 / $304.94	Professional	TC	$171.92	$214.08	$304.94
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.46 / $66.13 / $100.17	Professional	26	$60.46	$66.13	$100.17
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $50.93 / $93.20 / $166.54	Facility	26	$50.93	$93.20	$166.54
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $184.51 / $230.75 / $667.00	Professional		$184.51	$230.75	$667.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $44.19 / $51.55 / $143.63	Professional	26	$44.19	$51.55	$143.63
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $135.52 / $164.46 / $446.42	Professional	TC	$135.52	$164.46	$446.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $271.20 / $580.50 / $1,013.20	Professional		$271.20	$580.50	$1,013.20
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $59.80 / $59.80 / $59.80	Facility	26	$59.80	$59.80	$59.80
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $174.59 / $277.79 / $479.97	Professional		$174.59	$277.79	$479.97
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.15 / $63.65 / $107.59	Professional	26	$38.15	$63.65	$107.59
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $129.13 / $204.32 / $333.62	Professional	TC	$129.13	$204.32	$333.62
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $51.76 / $51.76 / $61.64	Facility	26	$51.76	$51.76	$61.64
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $199.32 / $202.56 / $250.18	Professional		$199.32	$202.56	$250.18
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $50.43 / $51.80 / $61.64	Professional	26	$50.43	$51.80	$61.64
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $147.52 / $150.79 / $188.54	Professional	TC	$147.52	$150.79	$188.54
United Facility/Professional Professional Modifier Low / Median / High Price $201.34 / $247.66 / $418.94	Professional		$201.34	$247.66	$418.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.05 / $62.24 / $109.13	Professional	26	$50.05	$62.24	$109.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $150.97 / $192.90 / $334.27	Professional	TC	$150.97	$192.90	$334.27