Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $207.99 / $287.23 / $701.38	Facility	26	$207.99	$287.23	$701.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $411.13 / $557.72 / $2,233.50	Professional		$411.13	$557.72	$2,233.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $198.28 / $264.94 / $991.76	Professional	26	$198.28	$264.94	$991.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $213.04 / $337.33 / $1,310.00	Professional	TC	$213.04	$337.33	$1,310.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $376.17 / $376.17 / $381.81	Professional		$376.17	$376.17	$381.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $174.63 / $217.97 / $428.64	Professional	26	$174.63	$217.97	$428.64
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $195.77 / $246.78 / $398.43	Professional	26	$195.77	$246.78	$398.43
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $474.46 / $755.62 / $2,176.17	Professional		$474.46	$755.62	$2,176.17
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $227.18 / $355.46 / $529.92	Professional	26	$227.18	$355.46	$529.92
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $247.28 / $399.60 / $1,772.91	Professional	TC	$247.28	$399.60	$1,772.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $256.04 / $256.04 / $256.04	Facility	26	$256.04	$256.04	$256.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $432.60 / $724.04 / $1,478.92	Professional		$432.60	$724.04	$1,478.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $183.26 / $274.33 / $437.62	Professional	26	$183.26	$274.33	$437.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $233.28 / $426.65 / $1,125.13	Professional	TC	$233.28	$426.65	$1,125.13
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $547.09 / $748.91 / $1,152.08	Professional		$547.09	$748.91	$1,152.08
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $250.96 / $303.01 / $337.84	Professional	26	$250.96	$303.01	$337.84
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $296.12 / $368.28 / $411.07	Professional	TC	$296.12	$368.28	$411.07
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $542.57 / $948.34 / $988.03	Professional		$542.57	$948.34	$988.03
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $243.75 / $265.70 / $368.20	Professional	26	$243.75	$265.70	$368.20
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $227.26 / $241.17 / $398.43	Professional	26	$227.26	$241.17	$398.43
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $207.99 / $334.32 / $734.25	Facility	26	$207.99	$334.32	$734.25
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $431.68 / $616.97 / $1,554.99	Professional		$431.68	$616.97	$1,554.99
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $207.95 / $315.62 / $652.02	Professional	26	$207.95	$315.62	$652.02
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $223.69 / $352.25 / $1,153.00	Professional	TC	$223.69	$352.25	$1,153.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $338.34 / $478.46 / $1,006.54	Professional		$338.34	$478.46	$1,006.54
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $256.04 / $256.04 / $256.04	Facility	26	$256.04	$256.04	$256.04
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $434.90 / $724.04 / $1,436.19	Professional		$434.90	$724.04	$1,436.19
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $191.99 / $274.33 / $439.77	Professional	26	$191.99	$274.33	$439.77
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $235.02 / $417.89 / $1,153.08	Professional	TC	$235.02	$417.89	$1,153.08
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $221.41 / $221.41 / $230.86	Facility	26	$221.41	$221.41	$230.86
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $454.83 / $461.31 / $1,185.30	Professional		$454.83	$461.31	$1,185.30
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $216.43 / $221.41 / $230.86	Professional	26	$216.43	$221.41	$230.86
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $234.93 / $239.91 / $954.44	Professional	TC	$234.93	$239.91	$954.44
United Facility/Professional Professional Modifier Low / Median / High Price $428.93 / $622.54 / $1,153.64	Professional		$428.93	$622.54	$1,153.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $204.89 / $261.80 / $422.30	Professional	26	$204.89	$261.80	$422.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $224.04 / $323.62 / $704.90	Professional	TC	$224.04	$323.62	$704.90