Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.95 / $96.89 / $219.66	Facility	26	$73.95	$96.89	$219.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $193.61 / $370.50 / $1,037.00	Professional		$193.61	$370.50	$1,037.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.16 / $90.05 / $154.00	Professional	26	$65.16	$90.05	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $126.62 / $158.32 / $368.50	Professional	TC	$126.62	$158.32	$368.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $132.38 / $151.91 / $179.07	Professional		$132.38	$151.91	$179.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.95 / $60.33 / $106.86	Professional	26	$56.95	$60.33	$106.86
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $215.36 / $309.05 / $461.14	Professional		$215.36	$309.05	$461.14
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $75.51 / $101.15 / $150.91	Professional	26	$75.51	$101.15	$150.91
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $139.85 / $207.93 / $310.25	Professional	TC	$139.85	$207.93	$310.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.45 / $86.45 / $86.45	Facility	26	$86.45	$86.45	$86.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.32 / $293.47 / $476.95	Professional		$179.32	$293.47	$476.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.08 / $92.61 / $150.02	Professional	26	$55.08	$92.61	$150.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $124.24 / $198.30 / $321.17	Professional	TC	$124.24	$198.30	$321.17
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $258.80 / $329.30 / $548.88	Professional		$258.80	$329.30	$548.88
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $82.62 / $103.27 / $170.82	Professional	26	$82.62	$103.27	$170.82
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $167.37 / $208.39 / $296.85	Professional	TC	$167.37	$208.39	$296.85
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.32 / $257.32 / $278.51	Professional		$257.32	$257.32	$278.51
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.86 / $92.43 / $131.08	Professional	26	$79.86	$92.43	$131.08
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $219.93 / $219.93 / $219.93	Professional	TC	$219.93	$219.93	$219.93
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $73.95 / $107.57 / $236.67	Facility	26	$73.95	$107.57	$236.67
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $202.11 / $391.85 / $1,320.50	Professional		$202.11	$391.85	$1,320.50
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $67.56 / $107.57 / $234.19	Professional	26	$67.56	$107.57	$234.19
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $134.16 / $187.34 / $385.24	Professional	TC	$134.16	$187.34	$385.24
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $107.23 / $261.04 / $406.10	Professional		$107.23	$261.04	$406.10
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $86.45 / $86.45 / $86.45	Facility	26	$86.45	$86.45	$86.45
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $190.95 / $293.47 / $478.09	Professional		$190.95	$293.47	$478.09
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $55.08 / $92.03 / $154.68	Professional	26	$55.08	$92.03	$154.68
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $125.25 / $198.30 / $321.17	Professional	TC	$125.25	$198.30	$321.17
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $75.01 / $75.01 / $89.01	Facility	26	$75.01	$75.01	$89.01
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $217.60 / $220.75 / $271.98	Professional		$217.60	$220.75	$271.98
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $73.11 / $75.03 / $89.01	Professional	26	$73.11	$75.03	$89.01
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $142.57 / $145.72 / $182.97	Professional	TC	$142.57	$145.72	$182.97
United Facility/Professional Professional Modifier Low / Median / High Price $218.82 / $337.57 / $989.25	Professional		$218.82	$337.57	$989.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.01 / $85.88 / $148.90	Professional	26	$70.01	$85.88	$148.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $146.38 / $211.09 / $872.43	Professional	TC	$146.38	$211.09	$872.43