Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.18 / $53.63 / $104.48	Facility	26	$35.18	$53.63	$104.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.18 / $144.44 / $381.86	Professional		$121.18	$144.44	$381.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.50 / $36.21 / $131.79	Professional	26	$30.50	$36.21	$131.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.04 / $108.88 / $207.79	Professional	TC	$93.04	$108.88	$207.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.61 / $36.94 / $59.22	Professional	26	$26.61	$36.94	$59.22
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $141.12 / $187.10 / $279.29	Professional		$141.12	$187.10	$279.29
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $35.90 / $47.90 / $70.78	Professional	26	$35.90	$47.90	$70.78
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $105.20 / $139.19 / $208.52	Professional	TC	$105.20	$139.19	$208.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.92 / $40.92 / $40.92	Facility	26	$40.92	$40.92	$40.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.50 / $174.20 / $282.00	Professional		$117.50	$174.20	$282.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.71 / $44.92 / $73.22	Professional	26	$28.71	$44.92	$73.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $88.13 / $130.58 / $211.51	Professional	TC	$88.13	$130.58	$211.51
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $152.46 / $203.90 / $349.59	Professional		$152.46	$203.90	$349.59
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.72 / $51.99 / $81.39	Professional	26	$40.72	$51.99	$81.39
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $131.41 / $168.97 / $268.20	Professional	TC	$131.41	$168.97	$268.20
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.79 / $183.01 / $183.01	Professional		$165.79	$183.01	$183.01
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.68 / $43.74 / $62.03	Professional	26	$38.68	$43.74	$62.03
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $35.18 / $55.81 / $112.58	Facility	26	$35.18	$55.81	$112.58
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $123.82 / $164.72 / $434.79	Professional		$123.82	$164.72	$434.79
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $32.03 / $45.62 / $107.45	Professional	26	$32.03	$45.62	$107.45
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $93.86 / $128.55 / $327.95	Professional	TC	$93.86	$128.55	$327.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $141.50 / $151.00 / $334.30	Professional		$141.50	$151.00	$334.30
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $40.92 / $40.92 / $40.92	Facility	26	$40.92	$40.92	$40.92
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $118.62 / $173.66 / $282.00	Professional		$118.62	$173.66	$282.00
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.37 / $44.92 / $73.22	Professional	26	$29.37	$44.92	$73.22
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $89.39 / $130.83 / $211.51	Professional	TC	$89.39	$130.83	$211.51
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $35.52 / $35.52 / $40.00	Facility	26	$35.52	$35.52	$40.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $119.00 / $142.68 / $154.80	Professional		$119.00	$142.68	$154.80
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $34.61 / $35.54 / $40.00	Professional	26	$34.61	$35.54	$40.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $79.00 / $107.16 / $117.98	Professional	TC	$79.00	$107.16	$117.98
United Facility/Professional Professional Modifier Low / Median / High Price $109.36 / $159.16 / $266.29	Professional		$109.36	$159.16	$266.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.91 / $41.26 / $71.27	Professional	26	$30.91	$41.26	$71.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.82 / $122.97 / $207.16	Professional	TC	$89.82	$122.97	$207.16