Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $386.67 / $533.97 / $1,303.20	Facility	26	$386.67	$533.97	$1,303.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,571.74 / $2,158.13 / $10,147.00	Professional		$1,571.74	$2,158.13	$10,147.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $360.87 / $534.10 / $1,736.54	Professional	26	$360.87	$534.10	$1,736.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $1,203.48 / $1,745.82 / $4,266.58	Professional	TC	$1,203.48	$1,745.82	$4,266.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,348.32 / $1,373.91 / $1,417.67	Professional		$1,348.32	$1,373.91	$1,417.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $335.25 / $618.83 / $779.92	Professional	26	$335.25	$618.83	$779.92
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $365.03 / $460.12 / $742.87	Professional	26	$365.03	$460.12	$742.87
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $1,786.52 / $2,478.53 / $3,477.65	Professional		$1,786.52	$2,478.53	$3,477.65
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $423.96 / $662.08 / $927.24	Professional	26	$423.96	$662.08	$927.24
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $1,362.57 / $1,772.91 / $2,722.84	Professional	TC	$1,362.57	$1,772.91	$2,722.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $477.29 / $477.29 / $477.29	Facility	26	$477.29	$477.29	$477.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,510.74 / $2,266.10 / $3,452.17	Professional		$1,510.74	$2,266.10	$3,452.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $341.00 / $486.93 / $788.30	Professional	26	$341.00	$486.93	$788.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,093.04 / $1,753.96 / $2,731.93	Professional	TC	$1,093.04	$1,753.96	$2,731.93
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $2,100.10 / $2,552.61 / $2,895.65	Professional		$2,100.10	$2,552.61	$2,895.65
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $468.55 / $565.49 / $631.34	Professional	26	$468.55	$565.49	$631.34
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,631.56 / $2,029.48 / $2,264.31	Professional	TC	$1,631.56	$2,029.48	$2,264.31
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,055.65 / $2,212.36 / $3,406.28	Professional		$2,055.65	$2,212.36	$3,406.28
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $429.55 / $493.59 / $685.65	Professional	26	$429.55	$493.59	$685.65
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $365.03 / $460.12 / $742.87	Professional	26	$365.03	$460.12	$742.87
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $386.67 / $623.20 / $1,364.29	Facility	26	$386.67	$623.20	$1,364.29
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $1,650.32 / $2,278.04 / $8,499.92	Professional		$1,650.32	$2,278.04	$8,499.92
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $368.26 / $561.74 / $1,160.00	Professional	26	$368.26	$561.74	$1,160.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $1,263.65 / $1,794.67 / $4,266.58	Professional	TC	$1,263.65	$1,794.67	$4,266.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $631.63 / $2,409.19 / $3,776.84	Professional		$631.63	$2,409.19	$3,776.84
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $477.29 / $477.29 / $477.29	Facility	26	$477.29	$477.29	$477.29
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $1,549.68 / $2,266.10 / $3,626.10	Professional		$1,549.68	$2,266.10	$3,626.10
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $356.95 / $494.82 / $814.77	Professional	26	$356.95	$494.82	$814.77
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,158.34 / $1,758.66 / $2,815.29	Professional	TC	$1,158.34	$1,758.66	$2,815.29
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $410.69 / $412.72 / $445.56	Facility	26	$410.69	$412.72	$445.56
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $1,365.13 / $1,754.57 / $2,007.04	Professional		$1,365.13	$1,754.57	$2,007.04
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $410.69 / $412.72 / $445.56	Professional	26	$410.69	$412.72	$445.56
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $954.44 / $1,341.85 / $1,477.30	Professional	TC	$954.44	$1,341.85	$1,477.30
United Facility/Professional Professional Modifier Low / Median / High Price $1,516.86 / $2,144.12 / $3,487.66	Professional		$1,516.86	$2,144.12	$3,487.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $381.47 / $493.94 / $786.22	Professional	26	$381.47	$493.94	$786.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,279.06 / $1,712.45 / $2,834.45	Professional	TC	$1,279.06	$1,712.45	$2,834.45