Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.33 / $94.90 / $196.96	Facility	26	$62.33	$94.90	$196.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $265.16 / $326.14 / $1,882.00	Professional		$265.16	$326.14	$1,882.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.24 / $63.36 / $336.00	Professional	26	$54.24	$63.36	$336.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $210.92 / $263.82 / $457.83	Professional	TC	$210.92	$263.82	$457.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.66 / $48.66 / $48.66	Professional	26	$48.66	$48.66	$48.66
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $295.23 / $454.27 / $614.36	Professional		$295.23	$454.27	$614.36
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $63.53 / $87.19 / $122.48	Professional	26	$63.53	$87.19	$122.48
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $231.71 / $367.10 / $491.87	Professional	TC	$231.71	$367.10	$491.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.06 / $73.06 / $73.06	Facility	26	$73.06	$73.06	$73.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $236.74 / $376.00 / $616.73	Professional		$236.74	$376.00	$616.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.98 / $77.97 / $120.53	Professional	26	$43.98	$77.97	$120.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $185.80 / $298.16 / $492.84	Professional	TC	$185.80	$298.16	$492.84
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $428.54 / $428.54 / $476.80	Professional		$428.54	$428.54	$476.80
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.31 / $83.31 / $92.42	Professional	26	$83.31	$83.31	$92.42
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $345.23 / $345.23 / $384.39	Professional	TC	$345.23	$345.23	$384.39
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.66 / $73.33 / $107.34	Professional	26	$66.66	$73.33	$107.34
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $62.33 / $99.25 / $203.82	Facility	26	$62.33	$99.25	$203.82
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $280.94 / $365.22 / $1,288.29	Professional		$280.94	$365.22	$1,288.29
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $56.31 / $70.50 / $246.20	Professional	26	$56.31	$70.50	$246.20
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $223.48 / $290.52 / $585.67	Professional	TC	$223.48	$290.52	$585.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $88.54 / $337.23 / $461.33	Professional		$88.54	$337.23	$461.33
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $73.06 / $73.06 / $73.06	Facility	26	$73.06	$73.06	$73.06
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $249.13 / $392.78 / $619.87	Professional		$249.13	$392.78	$619.87
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.32 / $78.12 / $126.44	Professional	26	$46.32	$78.12	$126.44
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $196.85 / $311.18 / $502.56	Professional	TC	$196.85	$311.18	$502.56
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $62.85 / $62.85 / $114.00	Facility	26	$62.85	$62.85	$114.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $296.58 / $301.83 / $367.75	Professional		$296.58	$301.83	$367.75
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $61.40 / $62.85 / $114.00	Professional	26	$61.40	$62.85	$114.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $233.85 / $238.99 / $263.10	Professional	TC	$233.85	$238.99	$263.10
United Facility/Professional Professional Modifier Low / Median / High Price $295.98 / $428.39 / $620.40	Professional		$295.98	$428.39	$620.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.69 / $82.29 / $128.85	Professional	26	$60.69	$82.29	$128.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $235.29 / $308.72 / $491.64	Professional	TC	$235.29	$308.72	$491.64