Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.53 / $85.84 / $207.08	Facility	26	$65.53	$85.84	$207.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $399.15 / $493.74 / $1,974.00	Professional		$399.15	$493.74	$1,974.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.16 / $70.55 / $261.00	Professional	26	$57.16	$70.55	$261.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.94 / $399.56 / $676.14	Professional	TC	$335.94	$399.56	$676.14
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.40 / $109.86 / $126.38	Professional	26	$51.40	$109.86	$126.38
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $408.97 / $541.80 / $792.59	Professional		$408.97	$541.80	$792.59
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $66.98 / $84.53 / $119.77	Professional	26	$66.98	$84.53	$119.77
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $342.00 / $457.28 / $672.82	Professional	TC	$342.00	$457.28	$672.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.76 / $76.76 / $76.76	Facility	26	$76.76	$76.76	$76.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $352.38 / $559.01 / $877.32	Professional		$352.38	$559.01	$877.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $80.54 / $132.91	Professional	26	$48.98	$80.54	$132.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $303.39 / $476.91 / $755.78	Professional	TC	$303.39	$476.91	$755.78
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $597.13 / $597.13 / $664.39	Professional		$597.13	$597.13	$664.39
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $87.51 / $87.51 / $97.34	Professional	26	$87.51	$87.51	$97.34
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $509.61 / $509.61 / $567.07	Professional	TC	$509.61	$509.61	$567.07
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.83 / $98.79 / $117.21	Professional	26	$69.83	$98.79	$117.21
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $65.53 / $99.60 / $214.28	Facility	26	$65.53	$99.60	$214.28
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $400.64 / $536.29 / $1,381.31	Professional		$400.64	$536.29	$1,381.31
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $60.56 / $87.83 / $214.71	Professional	26	$60.56	$87.83	$214.71
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $340.21 / $459.09 / $855.05	Professional	TC	$340.21	$459.09	$855.05
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $130.38 / $792.91 / $923.32	Professional		$130.38	$792.91	$923.32
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $76.76 / $76.76 / $76.76	Facility	26	$76.76	$76.76	$76.76
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $365.67 / $584.38 / $921.30	Professional		$365.67	$584.38	$921.30
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $85.30 / $132.93	Professional	26	$48.98	$85.30	$132.93
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $307.43 / $494.32 / $782.08	Professional	TC	$307.43	$494.32	$782.08
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $66.56 / $66.56 / $79.66	Facility	26	$66.56	$66.56	$79.66
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $418.88 / $426.62 / $527.20	Professional		$418.88	$426.62	$527.20
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $64.90 / $66.56 / $79.66	Professional	26	$64.90	$66.56	$79.66
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $352.32 / $360.06 / $447.54	Professional	TC	$352.32	$360.06	$447.54
United Facility/Professional Professional Modifier Low / Median / High Price $431.34 / $529.29 / $884.25	Professional		$431.34	$529.29	$884.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.62 / $79.91 / $133.47	Professional	26	$64.62	$79.91	$133.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $366.16 / $478.70 / $761.90	Professional	TC	$366.16	$478.70	$761.90