Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $108.78 / $261.31	Facility		$79.43	$108.78	$261.31
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.00 / $75.39 / $88.96	Facility	26	$31.00	$75.39	$88.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.56 / $66.20 / $101.11	Professional		$44.56	$66.20	$101.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.07 / $27.51 / $71.00	Professional	26	$17.07	$27.51	$71.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.91 / $50.20 / $67.04	Professional	TC	$28.91	$50.20	$67.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.80 / $41.06 / $41.06	Professional	26	$30.80	$41.06	$41.06
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $67.84 / $79.94 / $113.38	Professional		$67.84	$79.94	$113.38
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $21.76 / $31.82 / $69.22	Professional	26	$21.76	$31.82	$69.22
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $26.42 / $47.83 / $76.34	Professional	TC	$26.42	$47.83	$76.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $76.81 / $76.81 / $127.80	Facility		$76.81	$76.81	$127.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.15 / $47.15 / $47.15	Facility	26	$47.15	$47.15	$47.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.83 / $45.15 / $96.51	Professional		$31.83	$45.15	$96.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.26 / $14.75 / $36.15	Professional	26	$10.26	$14.75	$36.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.29 / $26.24 / $62.45	Professional	TC	$18.29	$26.24	$62.45
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $44.26 / $102.15 / $135.28	Professional		$44.26	$102.15	$135.28
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.36 / $30.21 / $39.78	Professional	26	$13.36	$30.21	$39.78
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $71.95 / $95.50	Professional	TC	$30.90	$71.95	$95.50
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $102.11 / $102.11 / $107.48	Facility		$102.11	$102.11	$107.48
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.09 / $74.09 / $92.79	Professional		$74.09	$74.09	$92.79
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.47 / $25.92 / $36.47	Professional	26	$22.47	$25.92	$36.47
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $152.00 / $261.31	Facility		$79.43	$152.00	$261.31
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $31.00 / $88.96 / $88.96	Facility	26	$31.00	$88.96	$88.96
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $50.46 / $77.43 / $176.68	Professional		$50.46	$77.43	$176.68
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $17.85 / $30.10 / $69.83	Professional	26	$17.85	$30.10	$69.83
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $32.61 / $54.87 / $117.43	Professional	TC	$32.61	$54.87	$117.43
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.80 / $70.04 / $124.79	Professional		$30.80	$70.04	$124.79
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $76.81 / $76.81 / $127.80	Facility		$76.81	$76.81	$127.80
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $47.15 / $47.15 / $47.15	Facility	26	$47.15	$47.15	$47.15
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $31.83 / $47.09 / $103.31	Professional		$31.83	$47.09	$103.31
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.26 / $20.25 / $35.21	Professional	26	$10.26	$20.25	$35.21
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.14 / $30.39 / $66.63	Professional	TC	$20.14	$30.39	$66.63
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $54.36 / $62.56 / $68.31	Professional		$54.36	$62.56	$68.31
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $21.45 / $21.97 / $30.23	Professional	26	$21.45	$21.97	$30.23
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $24.13 / $41.48 / $45.94	Professional	TC	$24.13	$41.48	$45.94
United Facility/Professional Professional Modifier Low / Median / High Price $33.10 / $60.19 / $94.35	Professional		$33.10	$60.19	$94.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.22 / $22.99 / $37.57	Professional	26	$13.22	$22.99	$37.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.32 / $37.20 / $60.07	Professional	TC	$22.32	$37.20	$60.07