Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.49 / $59.90 / $98.16	Facility	26	$57.49	$59.90	$98.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $328.32 / $420.05 / $827.40	Professional		$328.32	$420.05	$827.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.32 / $59.90 / $154.40	Professional	26	$51.32	$59.90	$154.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.79 / $363.07 / $567.61	Professional	TC	$281.79	$363.07	$567.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $386.38 / $437.19 / $869.02	Professional		$386.38	$437.19	$869.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.96 / $80.75 / $102.02	Professional	26	$48.96	$80.75	$102.02
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $260.77 / $449.06 / $743.55	Professional		$260.77	$449.06	$743.55
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $55.46 / $89.40 / $134.84	Professional	26	$55.46	$89.40	$134.84
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $158.15 / $391.51 / $643.74	Professional	TC	$158.15	$391.51	$643.74
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 $223.01 / $451.61 / $832.98	Professional		$223.01	$451.61	$832.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.32 / $70.64 / $123.92	Professional	26	$52.32	$70.64	$123.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $166.66 / $391.51 / $784.30	Professional	TC	$166.66	$391.51	$784.30
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $470.28 / $686.07 / $903.76	Professional		$470.28	$686.07	$903.76
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 $415.70 / $605.45 / $789.92	Professional	TC	$415.70	$605.45	$789.92
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $331.62 / $524.20 / $554.50	Professional		$331.62	$524.20	$554.50
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.22 / $67.84 / $96.10	Professional	26	$61.22	$67.84	$96.10
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $442.42 / $442.42 / $442.42	Professional	TC	$442.42	$442.42	$442.42
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $54.75 / $79.00 / $98.16	Facility	26	$54.75	$79.00	$98.16
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $338.67 / $480.60 / $1,057.77	Professional		$338.67	$480.60	$1,057.77
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $52.18 / $78.48 / $177.00	Professional	26	$52.18	$78.48	$177.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $287.33 / $418.80 / $798.80	Professional	TC	$287.33	$418.80	$798.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $66.06 / $445.50 / $785.03	Professional		$66.06	$445.50	$785.03
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 $223.01 / $481.19 / $947.30	Professional		$223.01	$481.19	$947.30
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.75 / $70.38 / $129.97	Professional	26	$52.75	$70.38	$129.97
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $170.26 / $409.72 / $814.61	Professional	TC	$170.26	$409.72	$814.61
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $54.58 / $54.58 / $66.86	Facility	26	$54.58	$54.58	$66.86
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $413.74 / $421.93 / $461.23	Professional		$413.74	$421.93	$461.23
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 $359.32 / $367.35 / $404.39	Professional	TC	$359.32	$367.35	$404.39
United Facility/Professional Professional Modifier Low / Median / High Price $207.10 / $441.38 / $800.81	Professional		$207.10	$441.38	$800.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.62 / $65.53 / $111.44	Professional	26	$50.62	$65.53	$111.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.03 / $381.14 / $706.46	Professional	TC	$165.03	$381.14	$706.46