Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.01 / $98.61 / $155.41	Facility	26	$77.01	$98.61	$155.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.21 / $162.44 / $478.79	Professional		$131.21	$162.44	$478.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.54 / $76.73 / $243.17	Professional	26	$52.54	$76.73	$243.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.61 / $97.59 / $192.00	Professional	TC	$66.61	$97.59	$192.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.40 / $95.50 / $95.50	Professional		$76.40	$95.50	$95.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.53 / $97.97 / $113.98	Professional	26	$53.53	$97.97	$113.98
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $123.89 / $184.82 / $232.13	Professional		$123.89	$184.82	$232.13
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $69.23 / $91.43 / $117.37	Professional	26	$69.23	$91.43	$117.37
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $54.66 / $91.53 / $120.17	Professional	TC	$54.66	$91.53	$120.17
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.31 / $79.31 / $79.31	Facility	26	$79.31	$79.31	$79.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.47 / $197.48 / $394.44	Professional		$112.47	$197.48	$394.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.25 / $75.98 / $125.72	Professional	26	$49.25	$75.98	$125.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $55.60 / $115.39 / $312.58	Professional	TC	$55.60	$115.39	$312.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $146.04 / $192.59 / $390.30	Professional		$146.04	$192.59	$390.30
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.76 / $94.47 / $101.89	Professional	26	$77.76	$94.47	$101.89
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $67.75 / $81.45 / $90.70	Professional	TC	$67.75	$81.45	$90.70
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.75 / $145.97 / $153.12	Professional		$144.75	$145.97	$153.12
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.08 / $80.93 / $111.84	Professional	26	$70.08	$80.93	$111.84
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $77.01 / $104.31 / $246.46	Facility	26	$77.01	$104.31	$246.46
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $131.22 / $170.58 / $453.25	Professional		$131.22	$170.58	$453.25
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $57.05 / $92.74 / $228.74	Professional	26	$57.05	$92.74	$228.74
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $67.28 / $97.59 / $220.00	Professional	TC	$67.28	$97.59	$220.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $51.14 / $120.64 / $325.00	Professional		$51.14	$120.64	$325.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $79.31 / $79.31 / $79.31	Facility	26	$79.31	$79.31	$79.31
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $114.05 / $194.57 / $394.28	Professional		$114.05	$194.57	$394.28
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.61 / $76.01 / $125.72	Professional	26	$50.61	$76.01	$125.72
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $55.60 / $107.89 / $312.58	Professional	TC	$55.60	$107.89	$312.58
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $61.39 / $69.08 / $69.08	Facility	26	$61.39	$69.08	$69.08
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $135.07 / $137.36 / $378.00	Professional		$135.07	$137.36	$378.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $61.39 / $69.08 / $71.56	Professional	26	$61.39	$69.08	$71.56
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $66.81 / $68.28 / $316.61	Professional	TC	$66.81	$68.28	$316.61
United Facility/Professional Professional Modifier Low / Median / High Price $130.28 / $181.71 / $326.47	Professional		$130.28	$181.71	$326.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.76 / $75.40 / $137.31	Professional	26	$54.76	$75.40	$137.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.09 / $87.71 / $199.20	Professional	TC	$62.09	$87.71	$199.20