Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.53 / $148.68 / $406.68	Facility		$63.53	$148.68	$406.68
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.73 / $208.57 / $246.11	Facility	26	$85.73	$208.57	$246.11
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $58.70 / $161.66 / $502.97	Facility	TC	$58.70	$161.66	$502.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.55 / $88.26 / $171.60	Professional		$60.55	$88.26	$171.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.12 / $122.33 / $509.70	Professional	26	$49.12	$122.33	$509.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.50 / $33.58 / $71.08	Professional	TC	$25.50	$33.58	$71.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.39 / $85.17 / $113.56	Professional	26	$28.39	$85.17	$113.56
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $36.58 / $36.58 / $36.58	Professional	TC	$36.58	$36.58	$36.58
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $60.27 / $62.58 / $80.03	Professional	26	$60.27	$62.58	$80.03
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $94.12 / $130.99 / $185.21	Facility	TC	$94.12	$130.99	$185.21
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $98.96 / $142.32 / $196.99	Professional		$98.96	$142.32	$196.99
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $60.19 / $86.13 / $147.37	Professional	26	$60.19	$86.13	$147.37
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $38.77 / $49.31 / $67.13	Professional	TC	$38.77	$49.31	$67.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.55 / $67.55 / $139.63	Facility		$67.55	$67.55	$139.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.98 / $91.98 / $91.98	Facility	26	$91.98	$91.98	$91.98
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $47.65 / $47.65 / $47.65	Facility	TC	$47.65	$47.65	$47.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.62 / $56.17 / $133.11	Professional		$41.62	$56.17	$133.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.37 / $37.31 / $89.05	Professional	26	$28.37	$37.31	$89.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.25 / $19.25 / $45.42	Professional	TC	$13.25	$19.25	$45.42
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $63.00 / $144.36 / $190.50	Professional		$63.00	$144.36	$190.50
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.00 / $83.83 / $110.07	Professional	26	$37.00	$83.83	$110.07
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.00 / $60.54 / $80.43	Professional	TC	$26.00	$60.54	$80.43
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.57 / $136.47 / $136.47	Professional		$135.57	$136.47	$136.47
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.23 / $69.87 / $98.77	Professional	26	$62.23	$69.87	$98.77
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $60.27 / $62.58 / $80.03	Professional	26	$60.27	$62.58	$80.03
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $95.65 / $153.00 / $413.34	Facility		$95.65	$153.00	$413.34
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $85.73 / $246.11 / $246.11	Facility	26	$85.73	$246.11	$246.11
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $58.70 / $160.57 / $429.80	Facility	TC	$58.70	$160.57	$429.80
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $79.40 / $100.67 / $235.29	Professional		$79.40	$100.67	$235.29
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $50.96 / $104.28 / $438.08	Professional	26	$50.96	$104.28	$438.08
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $30.79 / $41.22 / $81.87	Professional	TC	$30.79	$41.22	$81.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.52 / $85.37 / $169.35	Professional		$41.52	$85.37	$169.35
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $67.55 / $67.55 / $139.63	Facility		$67.55	$67.55	$139.63
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $91.98 / $91.98 / $91.98	Facility	26	$91.98	$91.98	$91.98
Priority Health Facility/Professional Facility Modifier TC Low / Median / High Price $47.65 / $47.65 / $47.65	Facility	TC	$47.65	$47.65	$47.65
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $41.62 / $66.56 / $144.07	Professional		$41.62	$66.56	$144.07
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.37 / $52.38 / $89.89	Professional	26	$28.37	$52.38	$89.89
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $13.25 / $21.43 / $49.38	Professional	TC	$13.25	$21.43	$49.38
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $76.03 / $97.34 / $104.80	Professional		$76.03	$97.34	$104.80
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $59.28 / $60.78 / $65.00	Professional	26	$59.28	$60.78	$65.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $11.95 / $38.64 / $42.80	Professional	TC	$11.95	$38.64	$42.80
United Facility/Professional Professional Modifier Low / Median / High Price $53.21 / $96.74 / $148.44	Professional		$53.21	$96.74	$148.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.15 / $63.93 / $95.90	Professional	26	$35.15	$63.93	$95.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.69 / $32.81 / $55.94	Professional	TC	$17.69	$32.81	$55.94