Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.46 / $71.79 / $161.77	Facility	26	$54.46	$71.79	$161.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.93 / $179.96 / $961.00	Professional		$151.93	$179.96	$961.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.12 / $61.62 / $288.00	Professional	26	$49.12	$61.62	$288.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $101.72 / $120.23 / $225.86	Professional	TC	$101.72	$120.23	$225.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.94 / $85.67 / $105.26	Professional	26	$42.94	$85.67	$105.26
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $170.52 / $176.96 / $318.19	Professional		$170.52	$176.96	$318.19
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $55.79 / $57.89 / $107.78	Professional	26	$55.79	$57.89	$107.78
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $114.73 / $119.06 / $210.43	Professional	TC	$114.73	$119.06	$210.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.82 / $63.82 / $63.82	Facility	26	$63.82	$63.82	$63.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.66 / $217.18 / $343.47	Professional		$139.66	$217.18	$343.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.82 / $68.39 / $106.02	Professional	26	$39.82	$68.39	$106.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $94.42 / $146.13 / $239.42	Professional	TC	$94.42	$146.13	$239.42
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $243.94 / $243.94 / $272.63	Professional		$243.94	$243.94	$272.63
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $73.09 / $73.09 / $81.65	Professional	26	$73.09	$73.09	$81.65
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $170.84 / $170.84 / $190.97	Professional	TC	$170.84	$170.84	$190.97
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.20 / $64.02 / $80.97	Professional	26	$58.20	$64.02	$80.97
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $54.46 / $79.47 / $174.30	Facility	26	$54.46	$79.47	$174.30
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $153.55 / $197.55 / $907.00	Professional		$153.55	$197.55	$907.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $51.54 / $73.16 / $173.03	Professional	26	$51.54	$73.16	$173.03
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $103.00 / $131.78 / $257.29	Professional	TC	$103.00	$131.78	$257.29
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $63.82 / $63.82 / $63.82	Facility	26	$63.82	$63.82	$63.82
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $140.19 / $227.86 / $343.47	Professional		$140.19	$227.86	$343.47
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.22 / $70.31 / $110.50	Professional	26	$43.22	$70.31	$110.50
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $98.09 / $154.77 / $239.42	Professional	TC	$98.09	$154.77	$239.42
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $54.88 / $54.88 / $62.50	Facility	26	$54.88	$54.88	$62.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $164.72 / $167.08 / $234.00	Professional		$164.72	$167.08	$234.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $53.57 / $54.88 / $62.50	Professional	26	$53.57	$54.88	$62.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $109.92 / $112.20 / $171.50	Professional	TC	$109.92	$112.20	$171.50
United Facility/Professional Professional Modifier Low / Median / High Price $156.55 / $206.74 / $320.92	Professional		$156.55	$206.74	$320.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.35 / $66.30 / $109.30	Professional	26	$53.35	$66.30	$109.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.20 / $135.52 / $216.76	Professional	TC	$103.20	$135.52	$216.76