Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.81 / $77.59 / $120.40	Facility	26	$64.81	$77.59	$120.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $174.45 / $229.24 / $942.49	Professional		$174.45	$229.24	$942.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.89 / $82.56 / $320.63	Professional	26	$63.89	$82.56	$320.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.63 / $142.71 / $223.61	Professional	TC	$109.63	$142.71	$223.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.39 / $80.03 / $124.84	Professional	26	$60.39	$80.03	$124.84
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $177.51 / $286.83 / $442.01	Professional		$177.51	$286.83	$442.01
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $67.86 / $109.46 / $178.43	Professional	26	$67.86	$109.46	$178.43
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $109.66 / $148.91 / $305.58	Professional	TC	$109.66	$148.91	$305.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.01 / $78.01 / $78.01	Facility	26	$78.01	$78.01	$78.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $175.11 / $246.51 / $420.27	Professional		$175.11	$246.51	$420.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.81 / $92.92 / $150.31	Professional	26	$66.81	$92.92	$150.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.50 / $149.74 / $262.16	Professional	TC	$102.50	$149.74	$262.16
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $144.00 / $226.21 / $373.78	Professional		$144.00	$226.21	$373.78
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.09 / $98.77 / $199.88	Professional	26	$81.09	$98.77	$199.88
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $142.78 / $181.94 / $368.17	Professional	TC	$142.78	$181.94	$368.17
Highmark BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $2,552.40 / $2,552.40 / $2,552.40	Facility	26	$2,552.40	$2,552.40	$2,552.40
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $64.81 / $92.69 / $387.17	Facility	26	$64.81	$92.69	$387.17
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $176.62 / $263.62 / $938.00	Professional		$176.62	$263.62	$938.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $64.81 / $100.82 / $311.94	Professional	26	$64.81	$100.82	$311.94
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $109.63 / $156.53 / $316.81	Professional	TC	$109.63	$156.53	$316.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $104.10 / $173.20 / $400.00	Professional		$104.10	$173.20	$400.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $78.01 / $78.01 / $78.01	Facility	26	$78.01	$78.01	$78.01
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $175.11 / $246.51 / $418.35	Professional		$175.11	$246.51	$418.35
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.81 / $92.60 / $158.10	Professional	26	$66.81	$92.60	$158.10
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $103.45 / $149.74 / $261.70	Professional	TC	$103.45	$149.74	$261.70
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $66.83 / $66.83 / $84.00	Facility	26	$66.83	$66.83	$84.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $175.88 / $178.42 / $215.00	Professional		$175.88	$178.42	$215.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $65.30 / $66.83 / $84.00	Professional	26	$65.30	$66.83	$84.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $109.20 / $111.59 / $131.00	Professional	TC	$109.20	$111.59	$131.00
United Facility/Professional Professional Modifier Low / Median / High Price $156.94 / $234.48 / $371.19	Professional		$156.94	$234.48	$371.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.39 / $91.78 / $142.63	Professional	26	$69.39	$91.78	$142.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.44 / $143.46 / $239.61	Professional	TC	$103.44	$143.46	$239.61