Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.94 / $25.95 / $80.70	Facility	26	$25.94	$25.95	$80.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.51 / $177.46 / $437.11	Professional		$144.51	$177.46	$437.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.80 / $25.76 / $62.37	Professional	26	$21.80	$25.76	$62.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.85 / $149.32 / $338.54	Professional	TC	$120.85	$149.32	$338.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.14 / $17.54 / $18.48	Professional	26	$17.14	$17.54	$18.48
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $152.85 / $246.14 / $391.96	Professional		$152.85	$246.14	$391.96
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $23.50 / $38.54 / $59.98	Professional	26	$23.50	$38.54	$59.98
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $129.36 / $207.62 / $331.97	Professional	TC	$129.36	$207.62	$331.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.06 / $27.06 / $27.06	Facility	26	$27.06	$27.06	$27.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.81 / $237.43 / $362.57	Professional		$146.81	$237.43	$362.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.17 / $30.88 / $50.35	Professional	26	$22.17	$30.88	$50.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $128.13 / $207.12 / $312.45	Professional	TC	$128.13	$207.12	$312.45
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $198.03 / $250.23 / $506.38	Professional		$198.03	$250.23	$506.38
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.35 / $35.39 / $71.62	Professional	26	$28.35	$35.39	$71.62
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $168.39 / $214.84 / $434.76	Professional	TC	$168.39	$214.84	$434.76
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.62 / $26.26 / $26.59	Professional	26	$24.62	$26.26	$26.59
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $25.94 / $35.40 / $87.19	Facility	26	$25.94	$35.40	$87.19
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $147.13 / $245.36 / $520.52	Professional		$147.13	$245.36	$520.52
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $22.60 / $32.19 / $66.34	Professional	26	$22.60	$32.19	$66.34
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $124.03 / $191.39 / $443.48	Professional	TC	$124.03	$191.39	$443.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.55 / $155.19 / $343.70	Professional		$41.55	$155.19	$343.70
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $27.06 / $27.06 / $27.06	Facility	26	$27.06	$27.06	$27.06
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $146.09 / $230.25 / $362.57	Professional		$146.09	$230.25	$362.57
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.17 / $30.88 / $53.68	Professional	26	$22.17	$30.88	$53.68
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $129.16 / $203.99 / $329.24	Professional	TC	$129.16	$203.99	$329.24
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $23.53 / $23.53 / $39.50	Facility	26	$23.53	$23.53	$39.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $147.87 / $150.27 / $226.00	Professional		$147.87	$150.27	$226.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $22.72 / $23.74 / $39.50	Professional	26	$22.72	$23.74	$39.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $124.13 / $126.75 / $186.50	Professional	TC	$124.13	$126.75	$186.50
United Facility/Professional Professional Modifier Low / Median / High Price $140.44 / $188.90 / $336.28	Professional		$140.44	$188.90	$336.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.31 / $29.82 / $51.43	Professional	26	$22.31	$29.82	$51.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $125.94 / $168.36 / $283.20	Professional	TC	$125.94	$168.36	$283.20