Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $200.88 / $204.60 / $661.34	Facility		$200.88	$204.60	$661.34
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.91 / $152.11 / $152.11	Facility	26	$128.91	$152.11	$152.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.56 / $127.80 / $270.12	Professional		$103.56	$127.80	$270.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.10 / $41.51 / $280.32	Professional	26	$29.10	$41.51	$280.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.95 / $95.05 / $162.72	Professional	TC	$68.95	$95.05	$162.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.31 / $77.31 / $77.31	Professional		$77.31	$77.31	$77.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.28 / $54.33 / $70.80	Professional	26	$18.28	$54.33	$70.80
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $121.44 / $121.44 / $121.44	Professional	TC	$121.44	$121.44	$121.44
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $166.25 / $205.96 / $284.24	Professional		$166.25	$205.96	$284.24
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $37.52 / $49.54 / $72.94	Professional	26	$37.52	$49.54	$72.94
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $128.72 / $133.58 / $220.88	Professional	TC	$128.72	$133.58	$220.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $222.27 / $222.27 / $528.48	Facility		$222.27	$222.27	$528.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $213.67 / $213.67 / $213.67	Facility	26	$213.67	$213.67	$213.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.64 / $93.11 / $201.69	Professional		$55.64	$93.11	$201.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.70 / $23.98 / $53.47	Professional	26	$17.70	$23.98	$53.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.02 / $68.98 / $149.19	Professional	TC	$36.02	$68.98	$149.19
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $109.23 / $253.11 / $334.25	Professional		$109.23	$253.11	$334.25
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.98 / $52.03 / $68.17	Professional	26	$22.98	$52.03	$68.17
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $86.24 / $201.07 / $266.06	Professional	TC	$86.24	$201.07	$266.06
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,676.76 / $1,676.76 / $1,676.76	Facility		$1,676.76	$1,676.76	$1,676.76
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $176.48 / $176.48 / $186.68	Professional		$176.48	$176.48	$186.68
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.84 / $43.27 / $61.57	Professional	26	$38.84	$43.27	$61.57
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $200.88 / $661.34 / $661.34	Facility		$200.88	$661.34	$661.34
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $152.11 / $152.11 / $152.11	Facility	26	$152.11	$152.11	$152.11
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $112.56 / $169.02 / $388.35	Professional		$112.56	$169.02	$388.35
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $30.26 / $55.37 / $257.81	Professional	26	$30.26	$55.37	$257.81
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $75.78 / $128.72 / $275.89	Professional	TC	$75.78	$128.72	$275.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $37.11 / $160.88 / $289.56	Professional		$37.11	$160.88	$289.56
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $222.27 / $222.27 / $528.48	Facility		$222.27	$222.27	$528.48
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $213.67 / $213.67 / $213.67	Facility	26	$213.67	$213.67	$213.67
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $55.64 / $103.27 / $216.79	Professional		$55.64	$103.27	$216.79
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.70 / $34.61 / $57.61	Professional	26	$17.70	$34.61	$57.61
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.02 / $70.59 / $163.94	Professional	TC	$36.02	$70.59	$163.94
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $122.29 / $158.77 / $173.94	Professional		$122.29	$158.77	$173.94
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $36.65 / $37.57 / $43.31	Professional	26	$36.65	$37.57	$43.31
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $78.97 / $122.68 / $135.72	Professional	TC	$78.97	$122.68	$135.72
United Facility/Professional Professional Modifier Low / Median / High Price $91.36 / $166.11 / $234.71	Professional		$91.36	$166.11	$234.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.57 / $39.29 / $64.29	Professional	26	$22.57	$39.29	$64.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.75 / $126.82 / $179.19	Professional	TC	$69.75	$126.82	$179.19