Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.87 / $225.56 / $516.07	Facility	26	$147.87	$225.56	$516.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $336.75 / $402.89 / $1,436.80	Professional		$336.75	$402.89	$1,436.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $126.17 / $141.58 / $327.25	Professional	26	$126.17	$141.58	$327.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $199.33 / $242.53 / $583.47	Professional	TC	$199.33	$242.53	$583.47
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $449.68 / $587.70 / $716.36	Professional		$449.68	$587.70	$716.36
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $153.77 / $239.95 / $276.68	Professional	26	$153.77	$239.95	$276.68
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $295.91 / $347.75 / $455.69	Professional	TC	$295.91	$347.75	$455.69
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $172.76 / $172.76 / $172.76	Facility	26	$172.76	$172.76	$172.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $337.03 / $463.46 / $795.95	Professional		$337.03	$463.46	$795.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $121.50 / $185.01 / $290.42	Professional	26	$121.50	$185.01	$290.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $193.70 / $283.45 / $471.23	Professional	TC	$193.70	$283.45	$471.23
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $447.15 / $581.32 / $720.98	Professional		$447.15	$581.32	$720.98
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $169.98 / $205.06 / $229.19	Professional	26	$169.98	$205.06	$229.19
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $354.33 / $440.73 / $491.79	Professional	TC	$354.33	$440.73	$491.79
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $152.96 / $180.89 / $256.52	Professional	26	$152.96	$180.89	$256.52
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $147.87 / $270.60 / $584.09	Facility	26	$147.87	$270.60	$584.09
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $336.75 / $442.49 / $1,436.80	Professional		$336.75	$442.49	$1,436.80
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $131.81 / $149.84 / $327.25	Professional	26	$131.81	$149.84	$327.25
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $199.33 / $280.06 / $583.47	Professional	TC	$199.33	$280.06	$583.47
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $229.13 / $486.11 / $865.80	Professional		$229.13	$486.11	$865.80
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $172.76 / $172.76 / $172.76	Facility	26	$172.76	$172.76	$172.76
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $347.89 / $472.25 / $796.26	Professional		$347.89	$472.25	$796.26
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $129.34 / $185.06 / $295.62	Professional	26	$129.34	$185.06	$295.62
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $201.02 / $283.45 / $509.98	Professional	TC	$201.02	$283.45	$509.98
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $149.38 / $149.38 / $162.24	Facility	26	$149.38	$149.38	$162.24
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $369.16 / $437.34 / $472.75	Professional		$369.16	$437.34	$472.75
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $146.03 / $149.38 / $162.24	Professional	26	$146.03	$149.38	$162.24
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $206.92 / $287.95 / $317.02	Professional	TC	$206.92	$287.95	$317.02
United Facility/Professional Professional Modifier Low / Median / High Price $350.09 / $459.32 / $764.46	Professional		$350.09	$459.32	$764.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $138.40 / $180.55 / $290.69	Professional	26	$138.40	$180.55	$290.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $219.80 / $290.66 / $478.67	Professional	TC	$219.80	$290.66	$478.67