Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $140.88 / $166.23 / $166.23	Facility	26	$140.88	$166.23	$166.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.47 / $114.35 / $578.21	Professional		$72.47	$114.35	$578.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $32.81 / $157.29	Professional	26	$25.70	$32.81	$157.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $82.70 / $414.41	Professional	TC	$46.77	$82.70	$414.41
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $59.61 / $59.61 / $59.61	Professional	26	$59.61	$59.61	$59.61
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $144.28 / $154.03 / $311.35	Professional		$144.28	$154.03	$311.35
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $41.30 / $53.65 / $173.82	Professional	26	$41.30	$53.65	$173.82
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $102.98 / $106.86 / $179.08	Professional	TC	$102.98	$106.86	$179.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.89 / $84.89 / $84.89	Facility	26	$84.89	$84.89	$84.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.95 / $113.82 / $224.26	Professional		$65.95	$113.82	$224.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.60 / $34.53 / $86.69	Professional	26	$19.60	$34.53	$86.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.48 / $73.06 / $135.80	Professional	TC	$42.48	$73.06	$135.80
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $94.23 / $217.79 / $287.89	Professional		$94.23	$217.79	$287.89
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.20 / $57.00 / $74.58	Professional	26	$25.20	$57.00	$74.58
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $69.03 / $160.79 / $213.31	Professional	TC	$69.03	$160.79	$213.31
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $150.97 / $150.97 / $150.97	Professional		$150.97	$150.97	$150.97
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.48 / $43.88 / $43.88	Professional	26	$41.48	$43.88	$43.88
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $166.23 / $166.23 / $166.23	Facility	26	$166.23	$166.23	$166.23
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $100.98 / $131.08 / $611.37	Professional		$100.98	$131.08	$611.37
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $31.65 / $45.99 / $166.23	Professional	26	$31.65	$45.99	$166.23
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $69.95 / $93.53 / $454.08	Professional	TC	$69.95	$93.53	$454.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $54.35 / $143.88 / $264.93	Professional		$54.35	$143.88	$264.93
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $84.89 / $84.89 / $84.89	Facility	26	$84.89	$84.89	$84.89
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $65.95 / $117.96 / $215.93	Professional		$65.95	$117.96	$215.93
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.60 / $39.65 / $80.02	Professional	26	$19.60	$39.65	$80.02
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.04 / $77.47 / $146.83	Professional	TC	$43.04	$77.47	$146.83
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $133.82 / $138.75 / $200.13	Professional		$133.82	$138.75	$200.13
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $40.07 / $41.06 / $113.00	Professional	26	$40.07	$41.06	$113.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $87.13 / $95.23 / $105.45	Professional	TC	$87.13	$95.23	$105.45
United Facility/Professional Professional Modifier Low / Median / High Price $83.45 / $133.88 / $248.23	Professional		$83.45	$133.88	$248.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.56 / $42.59 / $76.20	Professional	26	$25.56	$42.59	$76.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.93 / $84.89 / $160.13	Professional	TC	$50.93	$84.89	$160.13