Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.45 / $59.53 / $97.59	Facility	26	$54.45	$59.53	$97.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.81 / $366.53 / $663.25	Professional		$302.81	$366.53	$663.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.33 / $59.53 / $144.08	Professional	26	$51.33	$59.53	$144.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $239.26 / $305.05 / $492.02	Professional	TC	$239.26	$305.05	$492.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $332.09 / $395.10 / $572.90	Professional		$332.09	$395.10	$572.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.49 / $83.71 / $102.02	Professional	26	$53.49	$83.71	$102.02
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $354.54 / $424.59 / $511.65	Professional		$354.54	$424.59	$511.65
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $58.20 / $63.67 / $94.63	Professional	26	$58.20	$63.67	$94.63
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $340.16 / $400.19 / $646.11	Professional		$340.16	$400.19	$646.11
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $55.46 / $89.40 / $134.94	Professional	26	$55.46	$89.40	$134.94
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $265.23 / $328.52 / $549.77	Professional	TC	$265.23	$328.52	$549.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.88 / $63.88 / $63.88	Facility	26	$63.88	$63.88	$63.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $222.33 / $402.91 / $714.50	Professional		$222.33	$402.91	$714.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.32 / $70.64 / $123.16	Professional	26	$52.32	$70.64	$123.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $167.50 / $329.70 / $648.22	Professional	TC	$167.50	$329.70	$648.22
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $403.34 / $588.60 / $776.69	Professional		$403.34	$588.60	$776.69
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.58 / $80.61 / $109.25	Professional	26	$54.58	$80.61	$109.25
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $348.78 / $507.99 / $662.85	Professional	TC	$348.78	$507.99	$662.85
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.26 / $438.67 / $481.39	Professional		$65.26	$438.67	$481.39
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.60 / $67.76 / $105.33	Professional	26	$61.60	$67.76	$105.33
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $395.10 / $418.55 / $728.43	Professional		$395.10	$418.55	$728.43
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $58.20 / $63.67 / $114.19	Professional	26	$58.20	$63.67	$114.19
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $54.45 / $79.00 / $97.59	Facility	26	$54.45	$79.00	$97.59
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $302.82 / $428.25 / $852.01	Professional		$302.82	$428.25	$852.01
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $51.70 / $73.59 / $145.88	Professional	26	$51.70	$73.59	$145.88
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $251.27 / $347.75 / $679.11	Professional	TC	$251.27	$347.75	$679.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $66.06 / $378.43 / $656.84	Professional		$66.06	$378.43	$656.84
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $60.20 / $63.88 / $63.88	Facility	26	$60.20	$63.88	$63.88
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $233.82 / $417.42 / $829.90	Professional		$233.82	$417.42	$829.90
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.75 / $70.45 / $129.97	Professional	26	$52.75	$70.45	$129.97
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $167.80 / $350.11 / $696.08	Professional	TC	$167.80	$350.11	$696.08
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $54.58 / $54.58 / $62.50	Facility	26	$54.58	$54.58	$62.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $357.18 / $364.07 / $397.54	Professional		$357.18	$364.07	$397.54
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $53.37 / $54.58 / $56.83	Professional	26	$53.37	$54.58	$56.83
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $302.77 / $309.49 / $340.71	Professional	TC	$302.77	$309.49	$340.71
United Facility/Professional Professional Modifier Low / Median / High Price $193.15 / $375.54 / $689.49	Professional		$193.15	$375.54	$689.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.31 / $66.19 / $107.72	Professional	26	$50.31	$66.19	$107.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $161.35 / $314.13 / $569.17	Professional	TC	$161.35	$314.13	$569.17