Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.89 / $136.57 / $333.79	Facility	26	$98.89	$136.57	$333.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.76 / $200.97 / $744.49	Professional		$118.76	$200.97	$744.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.92 / $158.00 / $482.59	Professional	26	$90.92	$158.00	$482.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.19 / $72.90 / $149.44	Professional	TC	$23.19	$72.90	$149.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $111.54 / $111.54 / $111.54	Professional		$111.54	$111.54	$111.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $82.81 / $103.37 / $203.28	Professional	26	$82.81	$103.37	$203.28
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $144.91 / $211.10 / $892.60	Professional		$144.91	$211.10	$892.60
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $107.74 / $168.31 / $242.96	Professional	26	$107.74	$168.31	$242.96
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $37.18 / $50.20 / $707.71	Professional	TC	$37.18	$50.20	$707.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $121.50 / $121.50 / $121.50	Facility	26	$121.50	$121.50	$121.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.56 / $239.29 / $581.51	Professional		$129.56	$239.29	$581.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.27 / $127.20 / $202.96	Professional	26	$87.27	$127.20	$202.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.66 / $63.98 / $445.69	Professional	TC	$31.66	$63.98	$445.69
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $163.63 / $222.35 / $447.25	Professional		$163.63	$222.35	$447.25
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $119.04 / $143.75 / $160.25	Professional	26	$119.04	$143.75	$160.25
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $44.58 / $55.33 / $62.11	Professional	TC	$44.58	$55.33	$62.11
Highmark BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $725.38 / $725.38 / $725.38	Facility	26	$725.38	$725.38	$725.38
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $170.48 / $358.97 / $369.74	Professional		$170.48	$358.97	$369.74
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $115.69 / $123.17 / $173.61	Professional	26	$115.69	$123.17	$173.61
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $98.89 / $158.63 / $349.44	Facility	26	$98.89	$158.63	$349.44
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $127.94 / $206.44 / $572.47	Professional		$127.94	$206.44	$572.47
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $94.39 / $153.47 / $357.75	Professional	26	$94.39	$153.47	$357.75
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $26.73 / $55.47 / $142.07	Professional	TC	$26.73	$55.47	$142.07
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $59.10 / $203.28 / $299.77	Professional		$59.10	$203.28	$299.77
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $121.50 / $121.50 / $121.50	Facility	26	$121.50	$121.50	$121.50
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $129.56 / $236.24 / $576.25	Professional		$129.56	$236.24	$576.25
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.31 / $127.20 / $208.58	Professional	26	$91.31	$127.20	$208.58
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.66 / $63.98 / $452.98	Professional	TC	$31.66	$63.98	$452.98
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $105.06 / $105.06 / $115.00	Facility	26	$105.06	$105.06	$115.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $133.00 / $135.71 / $495.96	Professional		$133.00	$135.71	$495.96
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $102.61 / $105.06 / $115.00	Professional	26	$102.61	$105.06	$115.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $30.08 / $30.65 / $380.96	Professional	TC	$30.08	$30.65	$380.96
United Facility/Professional Professional Modifier Low / Median / High Price $122.23 / $187.42 / $446.53	Professional		$122.23	$187.42	$446.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $97.66 / $124.03 / $201.60	Professional	26	$97.66	$124.03	$201.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.40 / $38.59 / $219.66	Professional	TC	$22.40	$38.59	$219.66