Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.95 / $53.55 / $126.30	Facility	26	$38.95	$53.55	$126.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.15 / $204.65 / $776.00	Professional		$173.15	$204.65	$776.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.73 / $37.10 / $67.93	Professional	26	$22.73	$37.10	$67.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $136.35 / $167.34 / $275.93	Professional	TC	$136.35	$167.34	$275.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $117.01 / $146.26 / $146.26	Professional		$117.01	$146.26	$146.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.44 / $34.51 / $62.17	Professional	26	$29.44	$34.51	$62.17
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $189.52 / $306.80 / $376.84	Professional		$189.52	$306.80	$376.84
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $37.60 / $54.89 / $74.81	Professional	26	$37.60	$54.89	$74.81
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $151.93 / $245.93 / $334.50	Professional	TC	$151.93	$245.93	$334.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.28 / $43.28 / $43.28	Facility	26	$43.28	$43.28	$43.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $182.39 / $268.80 / $438.62	Professional		$182.39	$268.80	$438.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.94 / $39.39 / $70.95	Professional	26	$24.94	$39.39	$70.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $152.00 / $237.91 / $367.22	Professional	TC	$152.00	$237.91	$367.22
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $244.66 / $308.77 / $624.86	Professional		$244.66	$308.77	$624.86
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.28 / $56.31 / $113.96	Professional	26	$45.28	$56.31	$113.96
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $197.71 / $252.47 / $510.90	Professional	TC	$197.71	$252.47	$510.90
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $258.83 / $258.83 / $258.83	Professional		$258.83	$258.83	$258.83
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.82 / $42.01 / $46.80	Professional	26	$34.82	$42.01	$46.80
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $38.95 / $56.09 / $136.44	Facility	26	$38.95	$56.09	$136.44
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $180.94 / $230.43 / $647.84	Professional		$180.94	$230.43	$647.84
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $23.91 / $45.06 / $79.81	Professional	26	$23.91	$45.06	$79.81
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $147.49 / $193.85 / $451.72	Professional	TC	$147.49	$193.85	$451.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $227.40 / $244.00 / $530.79	Professional		$227.40	$244.00	$530.79
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $43.28 / $43.28 / $43.28	Facility	26	$43.28	$43.28	$43.28
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $181.12 / $266.58 / $444.55	Professional		$181.12	$266.58	$444.55
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.95 / $40.15 / $71.02	Professional	26	$24.95	$40.15	$71.02
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.86 / $236.31 / $367.33	Professional	TC	$151.86	$236.31	$367.33
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $32.92 / $37.15 / $37.15	Facility	26	$32.92	$37.15	$37.15
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $184.41 / $187.30 / $203.83	Professional		$184.41	$187.30	$203.83
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $32.92 / $37.40 / $38.53	Professional	26	$32.92	$37.40	$38.53
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $147.00 / $150.13 / $167.08	Professional	TC	$147.00	$150.13	$167.08
United Facility/Professional Professional Modifier Low / Median / High Price $170.45 / $238.87 / $402.66	Professional		$170.45	$238.87	$402.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.61 / $41.59 / $75.43	Professional	26	$24.61	$41.59	$75.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $148.76 / $201.16 / $334.80	Professional	TC	$148.76	$201.16	$334.80