Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.72 / $120.93 / $142.69	Facility	26	$49.72	$120.93	$142.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.16 / $112.74 / $260.77	Professional		$61.16	$112.74	$260.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.35 / $37.99 / $106.52	Professional	26	$24.35	$37.99	$106.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.81 / $81.42 / $174.91	Professional	TC	$36.81	$81.42	$174.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $65.79 / $65.79 / $65.79	Professional		$65.79	$65.79	$65.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $50.42 / $50.42 / $65.86	Professional	26	$50.42	$50.42	$65.86
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $130.08 / $144.74 / $237.33	Professional		$130.08	$144.74	$237.33
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $34.90 / $46.49 / $105.64	Professional	26	$34.90	$46.49	$105.64
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $49.43 / $108.52 / $180.72	Professional	TC	$49.43	$108.52	$180.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.39 / $63.39 / $63.39	Facility	26	$63.39	$63.39	$63.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.09 / $73.45 / $162.30	Professional		$45.09	$73.45	$162.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.94 / $22.72 / $55.06	Professional	26	$16.94	$22.72	$55.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.60 / $49.33 / $118.38	Professional	TC	$25.60	$49.33	$118.38
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $91.41 / $211.47 / $279.75	Professional		$91.41	$211.47	$279.75
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.31 / $48.21 / $63.16	Professional	26	$21.31	$48.21	$63.16
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $70.09 / $163.27 / $216.59	Professional	TC	$70.09	$163.27	$216.59
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.14 / $161.87 / $193.07	Professional		$94.14	$161.87	$193.07
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.95 / $41.16 / $62.79	Professional	26	$35.95	$41.16	$62.79
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $174.94 / $174.94 / $174.94	Professional	TC	$174.94	$174.94	$174.94
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $49.72 / $142.69 / $142.69	Facility	26	$49.72	$142.69	$142.69
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $91.54 / $126.50 / $598.40	Professional		$91.54	$126.50	$598.40
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $27.92 / $51.89 / $110.59	Professional	26	$27.92	$51.89	$110.59
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $55.57 / $95.19 / $455.66	Professional	TC	$55.57	$95.19	$455.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $34.44 / $129.52 / $238.19	Professional		$34.44	$129.52	$238.19
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $63.39 / $63.39 / $63.39	Facility	26	$63.39	$63.39	$63.39
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $45.65 / $79.01 / $175.31	Professional		$45.65	$79.01	$175.31
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.70 / $32.47 / $55.26	Professional	26	$16.70	$32.47	$55.26
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.60 / $54.76 / $126.35	Professional	TC	$25.60	$54.76	$126.35
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $74.72 / $143.61 / $157.25	Professional		$74.72	$143.61	$157.25
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $34.40 / $35.24 / $46.08	Professional	26	$34.40	$35.24	$46.08
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $28.63 / $109.77 / $121.46	Professional	TC	$28.63	$109.77	$121.46
United Facility/Professional Professional Modifier Low / Median / High Price $56.21 / $122.08 / $199.75	Professional		$56.21	$122.08	$199.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.15 / $36.86 / $60.31	Professional	26	$21.15	$36.86	$60.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.19 / $85.22 / $139.44	Professional	TC	$37.19	$85.22	$139.44