Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.46 / $46.38 / $80.29	Facility	26	$37.46	$46.38	$80.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $230.42 / $283.07 / $1,433.00	Professional		$230.42	$283.07	$1,433.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.50 / $47.46 / $123.41	Professional	26	$35.50	$47.46	$123.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $196.74 / $229.93 / $465.03	Professional	TC	$196.74	$229.93	$465.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.91 / $57.84 / $65.81	Professional	26	$31.91	$57.84	$65.81
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $46.38 / $51.31 / $919.00	Professional	26	$46.38	$51.31	$919.00
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $263.45 / $347.36 / $546.27	Professional		$263.45	$347.36	$546.27
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $41.48 / $67.54 / $100.74	Professional	26	$41.48	$67.54	$100.74
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $221.98 / $286.36 / $468.65	Professional	TC	$221.98	$286.36	$468.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.62 / $45.62 / $45.62	Facility	26	$45.62	$45.62	$45.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $198.58 / $285.57 / $492.74	Professional		$198.58	$285.57	$492.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.41 / $48.90 / $75.52	Professional	26	$28.41	$48.90	$75.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $162.83 / $237.66 / $426.27	Professional	TC	$162.83	$237.66	$426.27
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $371.10 / $371.10 / $413.66	Professional		$371.10	$371.10	$413.66
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.41 / $52.41 / $58.71	Professional	26	$52.41	$52.41	$58.71
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $318.69 / $318.69 / $354.95	Professional	TC	$318.69	$318.69	$354.95
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $284.98 / $284.98 / $284.98	Professional		$284.98	$284.98	$284.98
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.62 / $49.15 / $70.56	Professional	26	$41.62	$49.15	$70.56
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $46.38 / $49.80 / $919.00	Professional	26	$46.38	$49.80	$919.00
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $35.67 / $51.73 / $122.42	Facility	26	$35.67	$51.73	$122.42
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $244.14 / $317.38 / $1,228.00	Professional		$244.14	$317.38	$1,228.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $37.29 / $55.92 / $115.48	Professional	26	$37.29	$55.92	$115.48
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $208.46 / $255.76 / $526.54	Professional	TC	$208.46	$255.76	$526.54
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $45.62 / $45.62 / $45.62	Facility	26	$45.62	$45.62	$45.62
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $212.83 / $304.52 / $500.55	Professional		$212.83	$304.52	$500.55
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.81 / $49.97 / $78.58	Professional	26	$30.81	$49.97	$78.58
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $168.49 / $254.72 / $430.05	Professional	TC	$168.49	$254.72	$430.05
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $39.54 / $39.54 / $46.00	Facility	26	$39.54	$39.54	$46.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $230.50 / $262.72 / $286.64	Professional		$230.50	$262.72	$286.64
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $38.54 / $39.54 / $46.00	Professional	26	$38.54	$39.54	$46.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $184.50 / $223.18 / $245.70	Professional	TC	$184.50	$223.18	$245.70
United Facility/Professional Professional Modifier Low / Median / High Price $226.42 / $311.08 / $510.19	Professional		$226.42	$311.08	$510.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.61 / $49.35 / $81.11	Professional	26	$38.61	$49.35	$81.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $213.03 / $275.61 / $462.39	Professional	TC	$213.03	$275.61	$462.39