Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.14 / $119.84 / $297.48	Facility	26	$94.14	$119.84	$297.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $753.62 / $944.35 / $3,721.00	Professional		$753.62	$944.35	$3,721.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.97 / $98.89 / $379.00	Professional	26	$81.97	$98.89	$379.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $662.14 / $789.91 / $1,329.36	Professional	TC	$662.14	$789.91	$1,329.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $73.95 / $73.95 / $147.72	Professional	26	$73.95	$73.95	$147.72
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $769.07 / $798.09 / $1,489.06	Professional		$769.07	$798.09	$1,489.06
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $96.21 / $99.84 / $170.28	Professional	26	$96.21	$99.84	$170.28
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $672.87 / $698.26 / $1,318.78	Professional	TC	$672.87	$698.26	$1,318.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $110.04 / $110.04 / $110.04	Facility	26	$110.04	$110.04	$110.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $664.29 / $1,049.26 / $1,654.12	Professional		$664.29	$1,049.26	$1,654.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.67 / $115.89 / $188.96	Professional	26	$69.67	$115.89	$188.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $594.62 / $934.63 / $1,481.28	Professional	TC	$594.62	$934.63	$1,481.28
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,128.33 / $1,128.33 / $1,256.63	Professional		$1,128.33	$1,128.33	$1,256.63
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $125.81 / $125.81 / $140.27	Professional	26	$125.81	$125.81	$140.27
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,002.51 / $1,002.51 / $1,116.35	Professional	TC	$1,002.51	$1,002.51	$1,116.35
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.17 / $134.50 / $177.49	Professional	26	$100.17	$134.50	$177.49
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $94.14 / $137.04 / $307.83	Facility	26	$94.14	$137.04	$307.83
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $756.20 / $992.27 / $2,835.20	Professional		$756.20	$992.27	$2,835.20
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $86.84 / $106.15 / $364.00	Professional	26	$86.84	$106.15	$364.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $669.36 / $882.34 / $1,561.55	Professional	TC	$669.36	$882.34	$1,561.55
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $188.48 / $1,562.85 / $1,751.33	Professional		$188.48	$1,562.85	$1,751.33
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $110.04 / $110.04 / $110.04	Facility	26	$110.04	$110.04	$110.04
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $689.48 / $1,096.97 / $1,734.04	Professional		$689.48	$1,096.97	$1,734.04
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.77 / $122.52 / $190.97	Professional	26	$69.77	$122.52	$190.97
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $605.97 / $968.95 / $1,533.41	Professional	TC	$605.97	$968.95	$1,533.41
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $95.78 / $95.78 / $113.26	Facility	26	$95.78	$95.78	$113.26
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $790.48 / $805.80 / $990.46	Professional		$790.48	$805.80	$990.46
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $93.31 / $95.84 / $113.26	Professional	26	$93.31	$95.84	$113.26
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $694.64 / $710.02 / $877.20	Professional	TC	$694.64	$710.02	$877.20
United Facility/Professional Professional Modifier Low / Median / High Price $810.38 / $1,035.48 / $1,702.06	Professional		$810.38	$1,035.48	$1,702.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $92.67 / $118.40 / $194.63	Professional	26	$92.67	$118.40	$194.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $698.26 / $893.54 / $1,551.55	Professional	TC	$698.26	$893.54	$1,551.55