Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.78 / $85.78 / $138.19	Facility	26	$85.78	$85.78	$138.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.08 / $157.00 / $265.62	Professional		$130.08	$157.00	$265.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.70 / $82.02 / $167.39	Professional	26	$72.70	$82.02	$167.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.03 / $77.72 / $130.10	Professional	TC	$55.03	$77.72	$130.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $149.40 / $149.40 / $149.40	Professional	26	$149.40	$149.40	$149.40
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $150.69 / $156.38 / $156.38	Professional		$150.69	$156.38	$156.38
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $79.18 / $128.13 / $193.90	Professional	26	$79.18	$128.13	$193.90
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $62.05 / $91.07 / $158.43	Professional	TC	$62.05	$91.07	$158.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.04 / $91.04 / $91.04	Facility	26	$91.04	$91.04	$91.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.04 / $168.15 / $321.32	Professional		$107.04	$168.15	$321.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.70 / $100.84 / $177.45	Professional	26	$74.70	$100.84	$177.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.29 / $87.23 / $177.33	Professional	TC	$40.29	$87.23	$177.33
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $156.79 / $229.95 / $309.05	Professional		$156.79	$229.95	$309.05
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.98 / $115.17 / $156.01	Professional	26	$77.98	$115.17	$156.01
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $78.81 / $114.78 / $149.72	Professional	TC	$78.81	$114.78	$149.72
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $87.83 / $104.47 / $112.24	Professional	26	$87.83	$104.47	$112.24
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $85.78 / $138.19 / $138.19	Facility	26	$85.78	$138.19	$138.19
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $130.81 / $166.45 / $531.48	Professional		$130.81	$166.45	$531.48
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $74.70 / $85.78 / $208.63	Professional	26	$74.70	$85.78	$208.63
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $55.03 / $83.32 / $184.47	Professional	TC	$55.03	$83.32	$184.47
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $76.06 / $142.99 / $277.95	Professional		$76.06	$142.99	$277.95
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $86.51 / $91.04 / $91.04	Facility	26	$86.51	$91.04	$91.04
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $102.90 / $168.15 / $323.45	Professional		$102.90	$168.15	$323.45
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $75.87 / $101.03 / $185.23	Professional	26	$75.87	$101.03	$185.23
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.29 / $89.47 / $177.74	Professional	TC	$40.29	$89.47	$177.74
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $78.36 / $78.36 / $99.00	Facility	26	$78.36	$78.36	$99.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $152.65 / $154.87 / $165.85	Professional		$152.65	$154.87	$165.85
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $76.55 / $78.36 / $81.63	Professional	26	$76.55	$78.36	$81.63
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $74.84 / $76.50 / $84.22	Professional	TC	$74.84	$76.50	$84.22
United Facility/Professional Professional Modifier Low / Median / High Price $112.99 / $175.51 / $315.68	Professional		$112.99	$175.51	$315.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.88 / $96.80 / $159.40	Professional	26	$72.88	$96.80	$159.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $88.50 / $158.97	Professional	TC	$38.90	$88.50	$158.97