Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.59 / $93.85 / $241.59	Facility	26	$70.59	$93.85	$241.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $399.29 / $540.41 / $2,446.21	Professional		$399.29	$540.41	$2,446.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.62 / $79.93 / $215.00	Professional	26	$67.62	$79.93	$215.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $322.92 / $414.12 / $704.16	Professional	TC	$322.92	$414.12	$704.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $343.59 / $622.76 / $708.66	Professional		$343.59	$622.76	$708.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $59.99 / $108.23 / $137.85	Professional	26	$59.99	$108.23	$137.85
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $602.35 / $639.21 / $1,056.04	Professional		$602.35	$639.21	$1,056.04
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $79.19 / $98.87 / $163.35	Professional	26	$79.19	$98.87	$163.35
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $405.80 / $726.79 / $854.35	Professional		$405.80	$726.79	$854.35
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $74.93 / $124.48 / $144.24	Professional	26	$74.93	$124.48	$144.24
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $330.87 / $601.95 / $710.08	Professional	TC	$330.87	$601.95	$710.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.17 / $86.17 / $86.17	Facility	26	$86.17	$86.17	$86.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $325.41 / $516.82 / $852.96	Professional		$325.41	$516.82	$852.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.07 / $91.51 / $142.44	Professional	26	$52.07	$91.51	$142.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $265.32 / $425.83 / $707.66	Professional	TC	$265.32	$425.83	$707.66
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $591.23 / $591.23 / $658.48	Professional		$591.23	$591.23	$658.48
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $98.31 / $98.31 / $109.17	Professional	26	$98.31	$98.31	$109.17
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $492.91 / $492.91 / $549.29	Professional	TC	$492.91	$492.91	$549.29
Highmark BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $121.26 / $121.26 / $185.65	Facility	26	$121.26	$121.26	$185.65
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $433.12 / $458.16 / $488.28	Professional		$433.12	$458.16	$488.28
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $78.65 / $87.72 / $122.70	Professional	26	$78.65	$87.72	$122.70
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $602.35 / $674.63 / $1,056.04	Professional		$602.35	$674.63	$1,056.04
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $79.19 / $98.87 / $163.35	Professional	26	$79.19	$98.87	$163.35
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $68.01 / $98.61 / $236.42	Facility	26	$68.01	$98.61	$236.42
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $409.63 / $606.80 / $2,446.21	Professional		$409.63	$606.80	$2,446.21
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $69.88 / $92.24 / $209.85	Professional	26	$69.88	$92.24	$209.85
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $323.33 / $436.11 / $815.87	Professional	TC	$323.33	$436.11	$815.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $104.50 / $480.22 / $635.65	Professional		$104.50	$480.22	$635.65
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $86.17 / $86.17 / $86.17	Facility	26	$86.17	$86.17	$86.17
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $344.05 / $550.19 / $864.03	Professional		$344.05	$550.19	$864.03
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.84 / $92.45 / $149.87	Professional	26	$54.84	$92.45	$149.87
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $282.22 / $446.10 / $727.53	Professional	TC	$282.22	$446.10	$727.53
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $74.44 / $74.44 / $139.97	Facility	26	$74.44	$74.44	$139.97
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $410.66 / $418.05 / $636.28	Professional		$410.66	$418.05	$636.28
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $72.66 / $74.44 / $139.97	Professional	26	$72.66	$74.44	$139.97
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $336.30 / $343.61 / $496.30	Professional	TC	$336.30	$343.61	$496.30
United Facility/Professional Professional Modifier Low / Median / High Price $412.16 / $595.34 / $860.49	Professional		$412.16	$595.34	$860.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $71.54 / $95.38 / $156.91	Professional	26	$71.54	$95.38	$156.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $340.62 / $458.71 / $708.76	Professional	TC	$340.62	$458.71	$708.76