Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.79 / $552.65 / $2,324.78	Facility		$99.79	$552.65	$2,324.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.46 / $34.54 / $78.65	Facility	26	$22.46	$34.54	$78.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.01 / $125.21 / $222.94	Professional		$107.01	$125.21	$222.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $22.28 / $32.74	Professional	26	$11.77	$22.28	$32.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $92.88 / $105.09 / $163.27	Professional	TC	$92.88	$105.09	$163.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.71 / $107.71 / $238.57	Professional		$107.71	$107.71	$238.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.10 / $41.35 / $43.14	Professional	26	$20.10	$41.35	$43.14
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $127.43 / $132.24 / $242.16	Professional		$127.43	$132.24	$242.16
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $22.86 / $23.73 / $45.24	Professional	26	$22.86	$23.73	$45.24
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $104.57 / $108.52 / $202.68	Professional	TC	$104.57	$108.52	$202.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.68 / $214.07 / $374.58	Facility		$147.68	$214.07	$374.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.75 / $26.75 / $26.75	Facility	26	$26.75	$26.75	$26.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.79 / $203.77 / $339.54	Professional		$136.79	$203.77	$339.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.68 / $23.88 / $44.47	Professional	26	$13.68	$23.88	$44.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.40 / $182.51 / $298.63	Professional	TC	$117.40	$182.51	$298.63
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $247.51 / $247.51 / $247.51	Facility		$247.51	$247.51	$247.51
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $155.74 / $202.07 / $271.35	Professional		$155.74	$202.07	$271.35
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.24 / $31.50 / $46.03	Professional	26	$23.24	$31.50	$46.03
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $129.65 / $170.69 / $256.06	Professional	TC	$129.65	$170.69	$256.06
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.88 / $28.42 / $40.38	Professional	26	$25.88	$28.42	$40.38
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $47.21 / $185.38 / $1,488.14	Facility		$47.21	$185.38	$1,488.14
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $32.57 / $34.54 / $78.65	Facility	26	$32.57	$34.54	$78.65
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $109.01 / $148.01 / $320.45	Professional		$109.01	$148.01	$320.45
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $24.17 / $42.71	Professional	26	$11.77	$24.17	$42.71
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $95.35 / $121.75 / $255.83	Professional	TC	$95.35	$121.75	$255.83
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $140.60 / $140.60 / $140.60	Facility		$140.60	$140.60	$140.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $140.60 / $190.70 / $480.20	Professional		$140.60	$190.70	$480.20
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $147.68 / $214.07 / $342.91	Facility		$147.68	$214.07	$342.91
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $26.75 / $26.75 / $26.75	Facility	26	$26.75	$26.75	$26.75
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $133.16 / $201.49 / $334.33	Professional		$133.16	$201.49	$334.33
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.82 / $23.88 / $44.47	Professional	26	$13.82	$23.88	$44.47
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $112.30 / $180.96 / $300.58	Professional	TC	$112.30	$180.96	$300.58
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $122.77 / $122.77 / $122.77	Facility		$122.77	$122.77	$122.77
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $22.88 / $22.88 / $22.88	Facility	26	$22.88	$22.88	$22.88
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $120.99 / $123.79 / $154.00	Professional		$120.99	$123.79	$154.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $13.00 / $22.88 / $23.73	Professional	26	$13.00	$22.88	$23.73
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $97.76 / $101.84 / $141.00	Professional	TC	$97.76	$101.84	$141.00
United Facility/Professional Professional Modifier Low / Median / High Price $126.97 / $167.45 / $286.17	Professional		$126.97	$167.45	$286.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.52 / $25.22 / $42.03	Professional	26	$12.52	$25.22	$42.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $108.00 / $147.19 / $246.23	Professional	TC	$108.00	$147.19	$246.23