Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.84 / $244.00 / $499.85	Facility		$89.84	$244.00	$499.85
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.37 / $41.05 / $112.30	Facility	26	$23.37	$41.05	$112.30
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $83.54 / $228.51 / $940.00	Facility	TC	$83.54	$228.51	$940.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.78 / $71.75 / $340.00	Professional		$59.78	$71.75	$340.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.98 / $65.56 / $525.96	Professional	26	$19.98	$65.56	$525.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.00 / $47.70 / $256.31	Professional	TC	$41.00	$47.70	$256.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.77 / $43.99 / $140.77	Professional		$42.77	$43.99	$140.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.96 / $39.79 / $51.82	Professional	26	$12.96	$39.79	$51.82
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $62.07 / $62.07 / $62.07	Professional	TC	$62.07	$62.07	$62.07
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $146.93 / $204.49 / $289.13	Facility	TC	$146.93	$204.49	$289.13
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $93.26 / $112.13 / $149.63	Professional		$93.26	$112.13	$149.63
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $27.46 / $36.65 / $46.23	Professional	26	$27.46	$36.65	$46.23
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $65.79 / $75.48 / $103.41	Professional	TC	$65.79	$75.48	$103.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.04 / $104.04 / $176.16	Facility		$104.04	$104.04	$176.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.22 / $71.22 / $71.22	Facility	26	$71.22	$71.22	$71.22
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $104.94 / $104.94 / $104.94	Facility	TC	$104.94	$104.94	$104.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.15 / $52.82 / $116.83	Professional		$32.15	$52.82	$116.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.67 / $15.59 / $35.51	Professional	26	$10.67	$15.59	$35.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.46 / $35.25 / $80.48	Professional	TC	$21.46	$35.25	$80.48
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $60.90 / $140.90 / $185.83	Professional		$60.90	$140.90	$185.83
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.84 / $38.09 / $50.04	Professional	26	$16.84	$38.09	$50.04
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $44.06 / $102.80 / $135.79	Professional	TC	$44.06	$102.80	$135.79
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.41 / $98.88 / $132.43	Professional		$78.41	$98.88	$132.43
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.45 / $32.00 / $45.09	Professional	26	$26.45	$32.00	$45.09
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.04 / $53.32 / $115.87	Professional	TC	$34.04	$53.32	$115.87
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $89.84 / $244.00 / $499.85	Facility		$89.84	$244.00	$499.85
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $23.37 / $41.05 / $112.30	Facility	26	$23.37	$41.05	$112.30
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $93.72 / $228.51 / $878.64	Facility	TC	$93.72	$228.51	$878.64
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $67.41 / $89.84 / $225.87	Professional		$67.41	$89.84	$225.87
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $22.26 / $57.92 / $435.60	Professional	26	$22.26	$57.92	$435.60
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $46.34 / $62.07 / $157.06	Professional	TC	$46.34	$62.07	$157.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $36.15 / $87.58 / $159.99	Professional		$36.15	$87.58	$159.99
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $104.04 / $104.04 / $176.16	Facility		$104.04	$104.04	$176.16
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $71.22 / $71.22 / $71.22	Facility	26	$71.22	$71.22	$71.22
Priority Health Facility/Professional Facility Modifier TC Low / Median / High Price $104.94 / $104.94 / $104.94	Facility	TC	$104.94	$104.94	$104.94
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $32.15 / $59.48 / $120.67	Professional		$32.15	$59.48	$120.67
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.77 / $20.14 / $36.34	Professional	26	$10.77	$20.14	$36.34
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.46 / $39.43 / $83.64	Professional	TC	$21.46	$39.43	$83.64
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $70.63 / $81.70 / $89.14	Professional		$70.63	$81.70	$89.14
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $23.61 / $27.06 / $28.23	Professional	26	$23.61	$27.06	$28.23
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $47.03 / $55.08 / $60.90	Professional	TC	$47.03	$55.08	$60.90
United Facility/Professional Professional Modifier Low / Median / High Price $49.25 / $89.54 / $126.52	Professional		$49.25	$89.54	$126.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.96 / $29.01 / $47.14	Professional	26	$15.96	$29.01	$47.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.29 / $60.53 / $90.79	Professional	TC	$33.29	$60.53	$90.79