Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $215.81 / $254.66 / $254.66	Facility	26	$215.81	$254.66	$254.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.62 / $291.17 / $376.72	Professional		$189.62	$291.17	$376.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.58 / $56.35 / $308.87	Professional	26	$40.58	$56.35	$308.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $133.25 / $210.72 / $320.55	Professional	TC	$133.25	$210.72	$320.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $59.38 / $90.51 / $102.99	Professional	26	$59.38	$90.51	$102.99
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $373.15 / $387.23 / $648.03	Professional		$373.15	$387.23	$648.03
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $62.94 / $82.55 / $119.84	Professional	26	$62.94	$82.55	$119.84
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $256.70 / $321.92 / $541.90	Professional	TC	$256.70	$321.92	$541.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $243.03 / $243.03 / $243.03	Facility	26	$243.03	$243.03	$243.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.70 / $197.49 / $433.62	Professional		$101.70	$197.49	$433.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.69 / $40.21 / $88.07	Professional	26	$29.69	$40.21	$88.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.50 / $160.33 / $360.55	Professional	TC	$69.50	$160.33	$360.55
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $246.07 / $570.91 / $754.13	Professional		$246.07	$570.91	$754.13
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.22 / $86.48 / $113.32	Professional	26	$38.22	$86.48	$113.32
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $207.84 / $484.53 / $641.41	Professional	TC	$207.84	$484.53	$641.41
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.65 / $79.83 / $103.81	Professional	26	$64.65	$79.83	$103.81
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $254.66 / $254.66 / $254.66	Facility	26	$254.66	$254.66	$254.66
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $216.19 / $319.88 / $1,118.84	Professional		$216.19	$319.88	$1,118.84
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $48.27 / $71.29 / $335.62	Professional	26	$48.27	$71.29	$335.62
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $156.60 / $264.76 / $952.03	Professional	TC	$156.60	$264.76	$952.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $61.76 / $355.54 / $665.10	Professional		$61.76	$355.54	$665.10
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $243.03 / $243.03 / $243.03	Facility	26	$243.03	$243.03	$243.03
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $101.70 / $202.23 / $502.44	Professional		$101.70	$202.23	$502.44
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.69 / $57.96 / $94.60	Professional	26	$29.69	$57.96	$94.60
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $69.50 / $163.43 / $417.33	Professional	TC	$69.50	$163.43	$417.33
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $222.45 / $376.55 / $410.25	Professional		$222.45	$376.55	$410.25
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $61.40 / $61.66 / $70.80	Professional	26	$61.40	$61.66	$70.80
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $151.66 / $314.88 / $346.63	Professional	TC	$151.66	$314.88	$346.63
United Facility/Professional Professional Modifier Low / Median / High Price $213.98 / $387.23 / $549.74	Professional		$213.98	$387.23	$549.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.54 / $66.44 / $101.04	Professional	26	$36.54	$66.44	$101.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $145.18 / $322.62 / $520.30	Professional	TC	$145.18	$322.62	$520.30