Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.20 / $62.37 / $170.61	Facility	26	$36.20	$62.37	$170.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $182.03 / $237.43 / $303.91	Professional		$182.03	$237.43	$303.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.26 / $38.82 / $396.77	Professional	26	$28.26	$38.82	$396.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $143.21 / $203.15 / $265.72	Professional	TC	$143.21	$203.15	$265.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.72 / $57.72 / $57.72	Professional	26	$57.72	$57.72	$57.72
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $262.00 / $358.27 / $521.86	Professional		$262.00	$358.27	$521.86
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $40.79 / $56.70 / $82.36	Professional	26	$40.79	$56.70	$82.36
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $221.22 / $275.86 / $449.73	Professional	TC	$221.22	$275.86	$449.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.33 / $47.33 / $47.33	Facility	26	$47.33	$47.33	$47.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.73 / $177.34 / $354.65	Professional		$96.73	$177.34	$354.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.23 / $27.41 / $60.46	Professional	26	$19.23	$27.41	$60.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.68 / $139.21 / $285.77	Professional	TC	$74.68	$139.21	$285.77
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $172.93 / $401.31 / $530.24	Professional		$172.93	$401.31	$530.24
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.72 / $55.98 / $73.36	Professional	26	$24.72	$55.98	$73.36
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $148.21 / $345.53 / $457.35	Professional	TC	$148.21	$345.53	$457.35
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.48 / $43.88 / $73.65	Professional	26	$41.48	$43.88	$73.65
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $36.20 / $62.37 / $170.61	Facility	26	$36.20	$62.37	$170.61
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $182.03 / $257.92 / $500.04	Professional		$182.03	$257.92	$500.04
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $33.63 / $45.27 / $337.36	Professional	26	$33.63	$45.27	$337.36
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $150.26 / $219.50 / $437.87	Professional	TC	$150.26	$219.50	$437.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $40.11 / $248.07 / $472.28	Professional		$40.11	$248.07	$472.28
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $47.33 / $47.33 / $47.33	Facility	26	$47.33	$47.33	$47.33
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $96.73 / $179.34 / $390.23	Professional		$96.73	$179.34	$390.23
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.23 / $38.83 / $62.86	Professional	26	$19.23	$38.83	$62.86
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $74.68 / $141.52 / $327.37	Professional	TC	$74.68	$141.52	$327.37
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $211.64 / $287.91 / $314.10	Professional		$211.64	$287.91	$314.10
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $41.15 / $41.31 / $48.65	Professional	26	$41.15	$41.31	$48.65
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $162.97 / $246.60 / $271.45	Professional	TC	$162.97	$246.60	$271.45
United Facility/Professional Professional Modifier Low / Median / High Price $180.65 / $284.24 / $459.84	Professional		$180.65	$284.24	$459.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.98 / $45.41 / $68.12	Professional	26	$24.98	$45.41	$68.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $155.66 / $273.20 / $381.90	Professional	TC	$155.66	$273.20	$381.90