Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.54 / $95.03 / $95.03	Facility	26	$80.54	$95.03	$95.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.65 / $163.50 / $512.13	Professional		$75.65	$163.50	$512.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.79 / $20.30 / $138.00	Professional	26	$17.79	$20.30	$138.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.68 / $144.44 / $376.71	Professional	TC	$59.68	$144.44	$376.71
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $32.92 / $32.92 / $32.92	Professional	26	$32.92	$32.92	$32.92
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $186.62 / $193.67 / $313.66	Professional		$186.62	$193.67	$313.66
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $22.94 / $23.80 / $40.64	Professional	26	$22.94	$23.80	$40.64
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $163.69 / $169.86 / $275.97	Professional	TC	$163.69	$169.86	$275.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.94 / $90.94 / $90.94	Facility	26	$90.94	$90.94	$90.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.81 / $117.00 / $253.44	Professional		$78.81	$117.00	$253.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.05 / $26.45 / $62.62	Professional	26	$11.05	$26.45	$62.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.87 / $90.08 / $203.86	Professional	TC	$57.87	$90.08	$203.86
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $123.64 / $286.81 / $380.47	Professional		$123.64	$286.81	$380.47
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.90 / $31.44 / $41.19	Professional	26	$13.90	$31.44	$41.19
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $109.75 / $255.53 / $339.39	Professional	TC	$109.75	$255.53	$339.39
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.15 / $51.83 / $103.41	Professional	26	$38.15	$51.83	$103.41
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $95.03 / $95.03 / $95.03	Facility	26	$95.03	$95.03	$95.03
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $133.76 / $196.09 / $790.85	Professional		$133.76	$196.09	$790.85
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $17.79 / $34.04 / $148.47	Professional	26	$17.79	$34.04	$148.47
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $111.18 / $175.03 / $695.82	Professional	TC	$111.18	$175.03	$695.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $22.62 / $175.92 / $340.65	Professional		$22.62	$175.92	$340.65
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $90.94 / $90.94 / $90.94	Facility	26	$90.94	$90.94	$90.94
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $78.81 / $125.15 / $274.83	Professional		$78.81	$125.15	$274.83
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.87 / $26.45 / $62.62	Professional	26	$10.87	$26.45	$62.62
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $60.32 / $96.53 / $242.37	Professional	TC	$60.32	$96.53	$242.37
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $184.21 / $191.49 / $209.21	Professional		$184.21	$191.49	$209.21
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $22.96 / $23.47 / $60.46	Professional	26	$22.96	$23.47	$60.46
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $135.02 / $167.48 / $185.49	Professional	TC	$135.02	$167.48	$185.49
United Facility/Professional Professional Modifier Low / Median / High Price $96.74 / $172.69 / $244.01	Professional		$96.74	$172.69	$244.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.34 / $25.98 / $52.69	Professional	26	$15.34	$25.98	$52.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $84.76 / $151.54 / $282.58	Professional	TC	$84.76	$151.54	$282.58