Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.02 / $84.13 / $207.45	Facility	26	$57.02	$84.13	$207.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.75 / $127.38 / $277.80	Professional		$106.75	$127.38	$277.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.17 / $61.60 / $91.76	Professional	26	$52.17	$61.60	$91.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.59 / $63.38 / $182.08	Professional	TC	$50.59	$63.38	$182.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.50 / $100.50 / $100.50	Professional		$100.50	$100.50	$100.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.32 / $46.32 / $46.32	Professional	26	$46.32	$46.32	$46.32
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $114.37 / $140.88 / $224.29	Professional		$114.37	$140.88	$224.29
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $59.06 / $72.59 / $114.08	Professional	26	$59.06	$72.59	$114.08
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $55.30 / $68.28 / $111.55	Professional	TC	$55.30	$68.28	$111.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.87 / $67.87 / $67.87	Facility	26	$67.87	$67.87	$67.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.29 / $184.41 / $286.95	Professional		$113.29	$184.41	$286.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.72 / $76.59 / $123.72	Professional	26	$55.72	$76.59	$123.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $55.47 / $104.77 / $180.55	Professional	TC	$55.47	$104.77	$180.55
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $143.29 / $178.12 / $360.45	Professional		$143.29	$178.12	$360.45
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $70.75 / $86.36 / $174.76	Professional	26	$70.75	$86.36	$174.76
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $72.01 / $91.76 / $185.69	Professional	TC	$72.01	$91.76	$185.69
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.41 / $62.41 / $96.84	Professional	26	$62.41	$62.41	$96.84
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $61.74 / $87.29 / $230.29	Facility	26	$61.74	$87.29	$230.29
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $108.57 / $171.12 / $370.80	Professional		$108.57	$171.12	$370.80
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $55.39 / $71.12 / $162.72	Professional	26	$55.39	$71.12	$162.72
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $52.46 / $102.88 / $190.84	Professional	TC	$52.46	$102.88	$190.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $185.36 / $255.00 / $346.80	Professional		$185.36	$255.00	$346.80
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $67.87 / $67.87 / $67.87	Facility	26	$67.87	$67.87	$67.87
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $112.92 / $181.66 / $290.20	Professional		$112.92	$181.66	$290.20
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $55.72 / $76.59 / $127.71	Professional	26	$55.72	$76.59	$127.71
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $54.82 / $100.78 / $184.15	Professional	TC	$54.82	$100.78	$184.15
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $57.81 / $57.81 / $77.05	Facility	26	$57.81	$57.81	$77.05
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $110.54 / $112.19 / $224.36	Professional		$110.54	$112.19	$224.36
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $56.47 / $57.81 / $77.05	Professional	26	$56.47	$57.81	$77.05
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $53.21 / $54.37 / $147.31	Professional	TC	$53.21	$54.37	$147.31
United Facility/Professional Professional Modifier Low / Median / High Price $113.55 / $170.12 / $267.19	Professional		$113.55	$170.12	$267.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.87 / $74.05 / $122.53	Professional	26	$54.87	$74.05	$122.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $81.51 / $151.26	Professional	TC	$54.95	$81.51	$151.26