Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.20 / $83.60 / $578.86	Facility	26	$80.20	$83.60	$578.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.92 / $151.37 / $344.16	Professional		$125.92	$151.37	$344.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.68 / $78.64 / $166.32	Professional	26	$70.68	$78.64	$166.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.78 / $61.75 / $98.27	Professional	TC	$51.78	$61.75	$98.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.00 / $199.52 / $239.03	Professional		$114.00	$199.52	$239.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $67.78 / $118.98 / $128.38	Professional	26	$67.78	$118.98	$128.38
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $240.49 / $240.49 / $240.49	Professional		$240.49	$240.49	$240.49
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $129.93 / $202.27 / $268.11	Professional		$129.93	$202.27	$268.11
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $77.48 / $116.11 / $149.07	Professional	26	$77.48	$116.11	$149.07
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $52.44 / $86.99 / $121.29	Professional	TC	$52.44	$86.99	$121.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.73 / $88.73 / $88.73	Facility	26	$88.73	$88.73	$88.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.78 / $165.48 / $303.27	Professional		$104.78	$165.48	$303.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.94 / $101.04 / $175.67	Professional	26	$73.94	$101.04	$175.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.46 / $79.69 / $133.63	Professional	TC	$52.46	$79.69	$133.63
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $134.04 / $196.80 / $264.92	Professional		$134.04	$196.80	$264.92
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $76.19 / $112.58 / $152.66	Professional	26	$76.19	$112.58	$152.66
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $57.85 / $84.23 / $109.76	Professional	TC	$57.85	$84.23	$109.76
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.40 / $154.38 / $209.14	Professional		$144.40	$154.38	$209.14
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.36 / $94.25 / $132.94	Professional	26	$83.36	$94.25	$132.94
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $76.39 / $103.12 / $578.86	Facility	26	$76.39	$103.12	$578.86
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $129.32 / $182.21 / $381.77	Professional		$129.32	$182.21	$381.77
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $72.15 / $91.38 / $200.27	Professional	26	$72.15	$91.38	$200.27
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $67.67 / $128.55	Professional	TC	$53.70	$67.67	$128.55
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $62.53 / $124.64 / $238.12	Professional		$62.53	$124.64	$238.12
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $88.73 / $88.73 / $88.73	Facility	26	$88.73	$88.73	$88.73
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $103.64 / $165.08 / $306.45	Professional		$103.64	$165.08	$306.45
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.40 / $101.04 / $181.02	Professional	26	$74.40	$101.04	$181.02
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $52.46 / $79.20 / $138.18	Professional	TC	$52.46	$79.20	$138.18
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $70.26 / $76.39 / $76.39	Facility	26	$70.26	$76.39	$76.39
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $127.47 / $129.49 / $138.04	Professional		$127.47	$129.49	$138.04
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $74.67 / $76.39 / $79.56	Professional	26	$74.67	$76.39	$79.56
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $51.97 / $53.11 / $58.47	Professional	TC	$51.97	$53.11	$58.47
United Facility/Professional Professional Modifier Low / Median / High Price $128.02 / $161.44 / $280.27	Professional		$128.02	$161.44	$280.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.30 / $96.42 / $154.74	Professional	26	$72.30	$96.42	$154.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.94 / $73.22 / $123.85	Professional	TC	$52.94	$73.22	$123.85