Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.65 / $150.65 / $335.67	Facility	26	$102.65	$150.65	$335.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $361.30 / $441.88 / $1,048.63	Professional		$361.30	$441.88	$1,048.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.71 / $103.42 / $419.20	Professional	26	$90.71	$103.42	$419.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $253.52 / $323.22 / $560.37	Professional	TC	$253.52	$323.22	$560.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $314.07 / $314.07 / $314.07	Professional		$314.07	$314.07	$314.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.17 / $105.66 / $199.54	Professional	26	$81.17	$105.66	$199.54
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $388.96 / $671.69 / $829.60	Professional		$388.96	$671.69	$829.60
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $105.76 / $166.10 / $195.20	Professional	26	$105.76	$166.10	$195.20
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $283.20 / $493.72 / $640.38	Professional	TC	$283.20	$493.72	$640.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.59 / $119.59 / $119.59	Facility	26	$119.59	$119.59	$119.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $344.60 / $507.61 / $817.24	Professional		$344.60	$507.61	$817.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.25 / $127.44 / $200.10	Professional	26	$84.25	$127.44	$200.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $259.74 / $388.08 / $627.74	Professional	TC	$259.74	$388.08	$627.74
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $455.61 / $563.14 / $626.16	Professional		$455.61	$563.14	$626.16
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $116.76 / $141.09 / $156.96	Professional	26	$116.76	$141.09	$156.96
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $338.85 / $422.05 / $469.22	Professional	TC	$338.85	$422.05	$469.22
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $279.77 / $446.79 / $490.23	Professional		$279.77	$446.79	$490.23
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $109.61 / $118.43 / $174.81	Professional	26	$109.61	$118.43	$174.81
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $102.65 / $160.08 / $358.25	Facility	26	$102.65	$160.08	$358.25
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $366.94 / $469.69 / $1,109.34	Professional		$366.94	$469.69	$1,109.34
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $92.03 / $138.68 / $305.00	Professional	26	$92.03	$138.68	$305.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $268.61 / $363.85 / $951.79	Professional	TC	$268.61	$363.85	$951.79
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $157.44 / $509.90 / $748.60	Professional		$157.44	$509.90	$748.60
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $119.59 / $119.59 / $119.59	Facility	26	$119.59	$119.59	$119.59
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $355.51 / $517.02 / $839.04	Professional		$355.51	$517.02	$839.04
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $89.06 / $127.49 / $205.09	Professional	26	$89.06	$127.49	$205.09
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $267.35 / $392.28 / $633.19	Professional	TC	$267.35	$392.28	$633.19
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $103.11 / $103.11 / $112.00	Facility	26	$103.11	$103.11	$112.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $388.57 / $395.21 / $444.85	Professional		$388.57	$395.21	$444.85
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $100.82 / $103.11 / $112.00	Professional	26	$100.82	$103.11	$112.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $285.77 / $292.10 / $332.85	Professional	TC	$285.77	$292.10	$332.85
United Facility/Professional Professional Modifier Low / Median / High Price $392.83 / $501.95 / $854.74	Professional		$392.83	$501.95	$854.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $96.37 / $123.26 / $198.51	Professional	26	$96.37	$123.26	$198.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $290.68 / $379.51 / $622.66	Professional	TC	$290.68	$379.51	$622.66