Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.01 / $48.35 / $118.59	Facility	26	$35.01	$48.35	$118.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $191.65 / $262.62 / $958.00	Professional		$191.65	$262.62	$958.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.20 / $57.37 / $167.00	Professional	26	$32.20	$57.37	$167.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.51 / $215.59 / $786.00	Professional	TC	$158.51	$215.59	$786.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $204.71 / $204.71 / $204.71	Professional		$204.71	$204.71	$204.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.98 / $53.30 / $62.62	Professional	26	$28.98	$53.30	$62.62
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $257.29 / $281.86 / $489.29	Professional		$257.29	$281.86	$489.29
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $37.65 / $58.84 / $81.20	Professional	26	$37.65	$58.84	$81.20
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $219.63 / $227.92 / $422.83	Professional	TC	$219.63	$227.92	$422.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.72 / $42.72 / $42.72	Facility	26	$42.72	$42.72	$42.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $176.62 / $267.00 / $486.60	Professional		$176.62	$267.00	$486.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.38 / $42.84 / $71.20	Professional	26	$30.38	$42.84	$71.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.61 / $227.00 / $419.08	Professional	TC	$138.61	$227.00	$419.08
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $225.86 / $334.27 / $419.97	Professional		$225.86	$334.27	$419.97
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.68 / $50.33 / $56.19	Professional	26	$41.68	$50.33	$56.19
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $262.77 / $327.33 / $363.79	Professional	TC	$262.77	$327.33	$363.79
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $198.43 / $297.37 / $524.42	Professional		$198.43	$297.37	$524.42
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.72 / $43.25 / $59.97	Professional	26	$40.72	$43.25	$59.97
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $35.01 / $56.29 / $124.15	Facility	26	$35.01	$56.29	$124.15
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $191.77 / $301.08 / $811.67	Professional		$191.77	$301.08	$811.67
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $32.46 / $56.17 / $108.03	Professional	26	$32.46	$56.17	$108.03
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $160.25 / $257.52 / $786.00	Professional	TC	$160.25	$257.52	$786.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $56.17 / $358.23 / $498.68	Professional		$56.17	$358.23	$498.68
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $42.72 / $42.72 / $42.72	Facility	26	$42.72	$42.72	$42.72
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $177.34 / $284.14 / $489.80	Professional		$177.34	$284.14	$489.80
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.16 / $44.00 / $72.19	Professional	26	$31.16	$44.00	$72.19
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $143.13 / $244.80 / $422.54	Professional	TC	$143.13	$244.80	$422.54
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $37.28 / $37.28 / $38.50	Facility	26	$37.28	$37.28	$38.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $188.50 / $256.69 / $280.47	Professional		$188.50	$256.69	$280.47
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $36.40 / $37.28 / $38.94	Professional	26	$36.40	$37.28	$38.94
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $150.00 / $219.41 / $241.53	Professional	TC	$150.00	$219.41	$241.53
United Facility/Professional Professional Modifier Low / Median / High Price $164.93 / $280.19 / $492.76	Professional		$164.93	$280.19	$492.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.07 / $43.47 / $70.84	Professional	26	$33.07	$43.47	$70.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $167.43 / $248.12 / $429.37	Professional	TC	$167.43	$248.12	$429.37