Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.80 / $196.49 / $231.86	Facility	26	$80.80	$196.49	$231.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $392.91 / $481.54 / $632.10	Professional		$392.91	$481.54	$632.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.09 / $46.24 / $88.04	Professional	26	$37.09	$46.24	$88.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $355.82 / $435.29 / $565.21	Professional	TC	$355.82	$435.29	$565.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.40 / $26.40 / $93.26	Professional	26	$26.40	$26.40	$93.26
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $536.02 / $556.25 / $946.53	Professional		$536.02	$556.25	$946.53
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $56.72 / $58.86 / $96.07	Professional	26	$56.72	$58.86	$96.07
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $479.30 / $497.39 / $850.48	Professional	TC	$479.30	$497.39	$850.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.93 / $89.93 / $89.93	Facility	26	$89.93	$89.93	$89.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $252.84 / $416.99 / $776.81	Professional		$252.84	$416.99	$776.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.02 / $41.87 / $75.26	Professional	26	$27.02	$41.87	$75.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $226.09 / $366.50 / $700.12	Professional	TC	$226.09	$366.50	$700.12
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $355.74 / $827.04 / $1,093.18	Professional		$355.74	$827.04	$1,093.18
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.65 / $78.31 / $102.79	Professional	26	$34.65	$78.31	$102.79
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $321.10 / $748.73 / $990.39	Professional	TC	$321.10	$748.73	$990.39
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $625.52 / $625.52 / $625.52	Professional		$625.52	$625.52	$625.52
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $92.88 / $92.88 / $92.88	Professional	26	$92.88	$92.88	$92.88
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $80.80 / $231.86 / $231.86	Facility	26	$80.80	$231.86	$231.86
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $392.91 / $481.54 / $2,337.91	Professional		$392.91	$481.54	$2,337.91
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $43.67 / $51.43 / $231.86	Professional	26	$43.67	$51.43	$231.86
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $355.82 / $435.29 / $2,106.05	Professional	TC	$355.82	$435.29	$2,106.05
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $79.19 / $567.72 / $992.32	Professional		$79.19	$567.72	$992.32
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $89.93 / $89.93 / $89.93	Facility	26	$89.93	$89.93	$89.93
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $262.30 / $416.99 / $796.42	Professional		$262.30	$416.99	$796.42
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.96 / $43.56 / $82.52	Professional	26	$26.96	$43.56	$82.52
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $236.73 / $368.05 / $716.02	Professional	TC	$236.73	$368.05	$716.02
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $408.40 / $562.35 / $619.51	Professional		$408.40	$562.35	$619.51
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $48.34 / $55.91 / $58.16	Professional	26	$48.34	$55.91	$58.16
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $360.06 / $507.39 / $561.35	Professional	TC	$360.06	$507.39	$561.35
United Facility/Professional Professional Modifier Low / Median / High Price $305.24 / $554.98 / $832.47	Professional		$305.24	$554.98	$832.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.37 / $59.22 / $97.97	Professional	26	$31.37	$59.22	$97.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $285.08 / $495.76 / $811.16	Professional	TC	$285.08	$495.76	$811.16