Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.16 / $58.79 / $141.09	Facility	26	$43.16	$58.79	$141.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $188.86 / $228.16 / $1,262.00	Professional		$188.86	$228.16	$1,262.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.44 / $47.65 / $235.00	Professional	26	$39.44	$47.65	$235.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $148.01 / $182.68 / $303.39	Professional	TC	$148.01	$182.68	$303.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.90 / $34.90 / $36.92	Professional	26	$34.90	$34.90	$36.92
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $199.20 / $206.71 / $413.36	Professional		$199.20	$206.71	$413.36
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $45.36 / $47.07 / $87.85	Professional	26	$45.36	$47.07	$87.85
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $153.84 / $159.63 / $325.50	Professional	TC	$153.84	$159.63	$325.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.16 / $52.16 / $52.16	Facility	26	$52.16	$52.16	$52.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $167.52 / $282.42 / $440.44	Professional		$167.52	$282.42	$440.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.44 / $55.54 / $88.17	Professional	26	$32.44	$55.54	$88.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $131.25 / $220.30 / $354.53	Professional	TC	$131.25	$220.30	$354.53
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $288.60 / $288.60 / $322.02	Professional		$288.60	$288.60	$322.02
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $59.46 / $59.46 / $66.40	Professional	26	$59.46	$59.46	$66.40
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $229.13 / $229.13 / $255.62	Professional	TC	$229.13	$229.13	$255.62
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $45.01 / $48.93 / $52.38	Professional	26	$45.01	$48.93	$52.38
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $43.16 / $81.70 / $146.01	Facility	26	$43.16	$81.70	$146.01
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $189.12 / $255.30 / $651.64	Professional		$189.12	$255.30	$651.64
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $41.11 / $50.14 / $132.61	Professional	26	$41.11	$50.14	$132.61
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $148.01 / $197.14 / $519.05	Professional	TC	$148.01	$197.14	$519.05
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $63.31 / $221.05 / $311.16	Professional		$63.31	$221.05	$311.16
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $52.16 / $52.16 / $52.16	Facility	26	$52.16	$52.16	$52.16
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $180.71 / $285.41 / $444.25	Professional		$180.71	$285.41	$444.25
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.83 / $57.48 / $90.57	Professional	26	$34.83	$57.48	$90.57
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $145.13 / $229.33 / $356.08	Professional	TC	$145.13	$229.33	$356.08
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $44.87 / $44.87 / $53.50	Facility	26	$44.87	$44.87	$53.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $200.20 / $203.55 / $265.00	Professional		$200.20	$203.55	$265.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $43.77 / $44.87 / $53.50	Professional	26	$43.77	$44.87	$53.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $155.35 / $158.68 / $211.50	Professional	TC	$155.35	$158.68	$211.50
United Facility/Professional Professional Modifier Low / Median / High Price $200.20 / $258.43 / $410.40	Professional		$200.20	$258.43	$410.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.74 / $54.12 / $89.67	Professional	26	$43.74	$54.12	$89.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $156.46 / $198.12 / $320.73	Professional	TC	$156.46	$198.12	$320.73