Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.75 / $40.32 / $79.83	Facility	26	$36.75	$40.32	$79.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $228.33 / $278.31 / $599.50	Professional		$228.33	$278.31	$599.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.39 / $38.51 / $68.09	Professional	26	$34.39	$38.51	$68.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $189.08 / $235.97 / $350.94	Professional	TC	$189.08	$235.97	$350.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $215.15 / $215.15 / $215.15	Professional		$215.15	$215.15	$215.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.59 / $35.46 / $63.13	Professional	26	$33.59	$35.46	$63.13
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $236.56 / $342.41 / $478.29	Professional		$236.56	$342.41	$478.29
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $37.90 / $53.66 / $72.88	Professional	26	$37.90	$53.66	$72.88
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $198.64 / $288.76 / $405.43	Professional	TC	$198.64	$288.76	$405.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.98 / $42.98 / $42.98	Facility	26	$42.98	$42.98	$42.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $233.98 / $327.12 / $507.36	Professional		$233.98	$327.12	$507.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.76 / $48.33 / $76.33	Professional	26	$35.76	$48.33	$76.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $200.04 / $278.12 / $438.58	Professional	TC	$200.04	$278.12	$438.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $306.00 / $388.44 / $786.05	Professional		$306.00	$388.44	$786.05
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.07 / $58.71 / $118.81	Professional	26	$46.07	$58.71	$118.81
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $258.62 / $329.73 / $667.24	Professional	TC	$258.62	$329.73	$667.24
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.36 / $41.64 / $64.95	Professional	26	$39.36	$41.64	$64.95
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $36.75 / $53.28 / $125.40	Facility	26	$36.75	$53.28	$125.40
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $312.43 / $696.37	Professional		$234.42	$312.43	$696.37
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $35.67 / $44.10 / $87.45	Professional	26	$35.67	$44.10	$87.45
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $198.43 / $254.82 / $475.09	Professional	TC	$198.43	$254.82	$475.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $544.40 / $544.40 / $692.70	Professional		$544.40	$544.40	$692.70
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $42.98 / $42.98 / $42.98	Facility	26	$42.98	$42.98	$42.98
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $233.98 / $324.16 / $552.44	Professional		$233.98	$324.16	$552.44
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.76 / $48.33 / $83.41	Professional	26	$35.76	$48.33	$83.41
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $196.78 / $278.07 / $467.81	Professional	TC	$196.78	$278.07	$467.81
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $37.11 / $37.11 / $43.00	Facility	26	$37.11	$37.11	$43.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $233.14 / $236.90 / $282.20	Professional		$233.14	$236.90	$282.20
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $35.69 / $37.61 / $43.00	Professional	26	$35.69	$37.61	$43.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $195.53 / $199.78 / $239.21	Professional	TC	$195.53	$199.78	$239.21
United Facility/Professional Professional Modifier Low / Median / High Price $228.33 / $289.45 / $504.84	Professional		$228.33	$289.45	$504.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.46 / $43.96 / $74.53	Professional	26	$33.46	$43.96	$74.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $193.54 / $254.57 / $445.43	Professional	TC	$193.54	$254.57	$445.43