Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.40 / $162.82 / $192.13	Facility	26	$67.40	$162.82	$192.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $307.69 / $339.86 / $518.52	Professional		$307.69	$339.86	$518.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.74 / $40.39 / $51.50	Professional	26	$31.74	$40.39	$51.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $271.29 / $310.24 / $467.01	Professional	TC	$271.29	$310.24	$467.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $180.68 / $180.68 / $180.68	Professional		$180.68	$180.68	$180.68
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $389.00 / $403.68 / $721.39	Professional		$389.00	$403.68	$721.39
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $47.32 / $49.10 / $80.05	Professional	26	$47.32	$49.10	$80.05
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $341.68 / $354.57 / $642.45	Professional	TC	$341.68	$354.57	$642.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.99 / $53.99 / $53.99	Facility	26	$53.99	$53.99	$53.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $187.93 / $300.12 / $669.22	Professional		$187.93	$300.12	$669.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.32 / $30.29 / $66.06	Professional	26	$22.32	$30.29	$66.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $162.28 / $265.30 / $604.02	Professional	TC	$162.28	$265.30	$604.02
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $257.81 / $599.08 / $791.85	Professional		$257.81	$599.08	$791.85
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.93 / $65.33 / $85.89	Professional	26	$28.93	$65.33	$85.89
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $228.89 / $533.75 / $705.96	Professional	TC	$228.89	$533.75	$705.96
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $452.50 / $452.50 / $452.50	Professional		$452.50	$452.50	$452.50
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.27 / $48.74 / $50.36	Professional	26	$48.27	$48.74	$50.36
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $67.40 / $192.13 / $192.13	Facility	26	$67.40	$192.13	$192.13
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $307.69 / $393.75 / $1,644.07	Professional		$307.69	$393.75	$1,644.07
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $32.14 / $42.55 / $192.13	Professional	26	$32.14	$42.55	$192.13
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $271.29 / $351.12 / $1,451.98	Professional	TC	$271.29	$351.12	$1,451.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $66.06 / $411.54 / $719.62	Professional		$66.06	$411.54	$719.62
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $53.99 / $53.99 / $53.99	Facility	26	$53.99	$53.99	$53.99
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $185.37 / $352.09 / $677.94	Professional		$185.37	$352.09	$677.94
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.32 / $43.72 / $72.76	Professional	26	$22.32	$43.72	$72.76
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $162.28 / $306.70 / $611.89	Professional	TC	$162.28	$306.70	$611.89
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $344.78 / $398.08 / $435.18	Professional		$344.78	$398.08	$435.18
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $42.94 / $46.52 / $48.75	Professional	26	$42.94	$46.52	$48.75
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $301.85 / $350.35 / $387.00	Professional	TC	$301.85	$350.35	$387.00
United Facility/Professional Professional Modifier Low / Median / High Price $233.38 / $424.32 / $671.57	Professional		$233.38	$424.32	$671.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.49 / $49.97 / $74.95	Professional	26	$27.49	$49.97	$74.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $205.89 / $374.35 / $561.52	Professional	TC	$205.89	$374.35	$561.52