Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.07 / $90.82 / $124.84	Facility	26	$87.07	$90.82	$124.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.94 / $403.84 / $662.57	Professional		$346.94	$403.84	$662.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.18 / $90.76 / $230.02	Professional	26	$78.18	$90.76	$230.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $265.87 / $321.12 / $483.35	Professional	TC	$265.87	$321.12	$483.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $266.33 / $266.33 / $266.33	Professional		$266.33	$266.33	$266.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $73.37 / $102.36 / $158.22	Professional	26	$73.37	$102.36	$158.22
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $376.19 / $442.58 / $726.95	Professional		$376.19	$442.58	$726.95
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $83.86 / $122.16 / $208.27	Professional	26	$83.86	$122.16	$208.27
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $267.88 / $355.56 / $583.58	Professional	TC	$267.88	$355.56	$583.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.38 / $96.38 / $96.38	Facility	26	$96.38	$96.38	$96.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $297.29 / $482.56 / $851.56	Professional		$297.29	$482.56	$851.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.11 / $110.08 / $189.30	Professional	26	$79.11	$110.08	$189.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $211.20 / $375.41 / $684.16	Professional	TC	$211.20	$375.41	$684.16
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $459.94 / $671.64 / $889.59	Professional		$459.94	$671.64	$889.59
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $82.52 / $121.89 / $165.21	Professional	26	$82.52	$121.89	$165.21
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $377.42 / $549.73 / $717.47	Professional	TC	$377.42	$549.73	$717.47
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $491.17 / $540.29 / $568.85	Professional		$491.17	$540.29	$568.85
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.02 / $100.50 / $145.12	Professional	26	$93.02	$100.50	$145.12
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $87.07 / $119.45 / $147.78	Facility	26	$87.07	$119.45	$147.78
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $365.98 / $457.11 / $953.56	Professional		$365.98	$457.11	$953.56
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $81.22 / $119.45 / $238.54	Professional	26	$81.22	$119.45	$238.54
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $284.67 / $358.03 / $766.07	Professional	TC	$284.67	$358.03	$766.07
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $99.88 / $415.01 / $739.28	Professional		$99.88	$415.01	$739.28
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $95.18 / $96.38 / $96.38	Facility	26	$95.18	$96.38	$96.38
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $312.20 / $494.80 / $970.36	Professional		$312.20	$494.80	$970.36
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $80.31 / $110.08 / $196.12	Professional	26	$80.31	$110.08	$196.12
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $215.85 / $393.06 / $782.47	Professional	TC	$215.85	$393.06	$782.47
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $82.68 / $82.68 / $95.00	Facility	26	$82.68	$82.68	$95.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $401.63 / $408.93 / $445.26	Professional		$401.63	$408.93	$445.26
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $80.79 / $82.68 / $86.11	Professional	26	$80.79	$82.68	$86.11
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $319.14 / $326.25 / $359.15	Professional	TC	$319.14	$326.25	$359.15
United Facility/Professional Professional Modifier Low / Median / High Price $269.79 / $422.47 / $754.63	Professional		$269.79	$422.47	$754.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.11 / $101.17 / $168.19	Professional	26	$79.11	$101.17	$168.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $198.54 / $352.38 / $604.98	Professional	TC	$198.54	$352.38	$604.98