Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.46 / $47.73 / $91.97	Facility	26	$45.46	$47.73	$91.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.28 / $165.75 / $488.51	Professional		$92.28	$165.75	$488.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.86 / $59.29 / $172.32	Professional	26	$42.86	$59.29	$172.32
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $43.11 / $52.38 / $116.41	Professional	52	$43.11	$52.38	$116.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.82 / $95.13 / $156.10	Professional	TC	$46.82	$95.13	$156.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.26 / $141.26 / $177.75	Professional		$141.26	$141.26	$177.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.57 / $61.31 / $67.91	Professional	26	$17.57	$61.31	$67.91
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $68.80 / $68.80 / $68.80	Professional	26	$68.80	$68.80	$68.80
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $93.86 / $97.40 / $299.20	Professional		$93.86	$97.40	$299.20
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $43.32 / $44.96 / $111.52	Professional	26	$43.32	$44.96	$111.52
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $50.54 / $52.45 / $187.71	Professional	TC	$50.54	$52.45	$187.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.80 / $49.80 / $49.80	Facility	26	$49.80	$49.80	$49.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.58 / $203.71 / $308.27	Professional		$89.58	$203.71	$308.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.06 / $78.01 / $124.16	Professional	26	$42.06	$78.01	$124.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.52 / $118.11 / $198.62	Professional	TC	$47.52	$118.11	$198.62
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $97.99 / $143.61 / $192.83	Professional		$97.99	$143.61	$192.83
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.03 / $62.22 / $84.55	Professional	26	$42.03	$62.22	$84.55
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $55.96 / $81.39 / $105.61	Professional	TC	$55.96	$81.39	$105.61
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.91 / $50.91 / $50.91	Professional		$50.91	$50.91	$50.91
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.99 / $53.21 / $89.92	Professional	26	$47.99	$53.21	$89.92
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $68.80 / $68.80 / $92.12	Professional	26	$68.80	$68.80	$92.12
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $46.45 / $54.55 / $120.31	Facility	26	$46.45	$54.55	$120.31
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $92.28 / $170.64 / $599.26	Professional		$92.28	$170.64	$599.26
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $45.46 / $65.20 / $172.32	Professional	26	$45.46	$65.20	$172.32
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $43.11 / $63.87 / $314.14	Professional	52	$43.11	$63.87	$314.14
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $46.82 / $85.14 / $197.91	Professional	TC	$46.82	$85.14	$197.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $64.78 / $132.82 / $248.00	Professional		$64.78	$132.82	$248.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $49.80 / $49.80 / $84.90	Facility	26	$49.80	$49.80	$84.90
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $89.58 / $201.25 / $312.33	Professional		$89.58	$201.25	$312.33
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.76 / $77.50 / $126.89	Professional	26	$41.76	$77.50	$126.89
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $47.68 / $115.18 / $198.62	Professional	TC	$47.68	$115.18	$198.62
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $42.86 / $42.86 / $82.69	Facility	26	$42.86	$42.86	$82.69
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $87.30 / $88.69 / $94.84	Professional		$87.30	$88.69	$94.84
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $41.80 / $42.86 / $44.38	Professional	26	$41.80	$42.86	$44.38
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $44.91 / $45.83 / $50.46	Professional	TC	$44.91	$45.83	$50.46
United Facility/Professional Professional Modifier Low / Median / High Price $97.41 / $168.34 / $266.42	Professional		$97.41	$168.34	$266.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.86 / $64.16 / $102.23	Professional	26	$40.86	$64.16	$102.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.71 / $93.04 / $156.66	Professional	TC	$58.71	$93.04	$156.66