Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $188.10 / $195.70 / $1,087.94	Facility	26	$188.10	$195.70	$1,087.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $264.08 / $308.01 / $691.54	Professional		$264.08	$308.01	$691.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $166.71 / $187.16 / $384.68	Professional	26	$166.71	$187.16	$384.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.79 / $115.98 / $174.46	Professional	TC	$93.79	$115.98	$174.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $255.49 / $415.95 / $463.39	Professional		$255.49	$415.95	$463.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $224.02 / $281.14 / $345.44	Professional	26	$224.02	$281.14	$345.44
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $279.07 / $421.02 / $568.64	Professional		$279.07	$421.02	$568.64
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $183.08 / $273.52 / $354.41	Professional	26	$183.08	$273.52	$354.41
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $95.98 / $147.52 / $214.24	Professional	TC	$95.98	$147.52	$214.24
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $208.62 / $208.62 / $208.62	Facility	26	$208.62	$208.62	$208.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.48 / $355.41 / $646.08	Professional		$123.48	$355.41	$646.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $173.85 / $239.25 / $412.47	Professional	26	$173.85	$239.25	$412.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.08 / $147.43 / $242.71	Professional	TC	$95.08	$147.43	$242.71
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $286.47 / $420.73 / $566.35	Professional		$286.47	$420.73	$566.35
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $180.55 / $266.52 / $360.87	Professional	26	$180.55	$266.52	$360.87
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $105.91 / $154.19 / $200.86	Professional	TC	$105.91	$154.19	$200.86
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $298.14 / $326.36 / $471.37	Professional		$298.14	$326.36	$471.37
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $197.81 / $215.49 / $320.18	Professional	26	$197.81	$215.49	$320.18
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $179.15 / $217.69 / $1,087.94	Facility	26	$179.15	$217.69	$1,087.94
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $275.32 / $364.48 / $800.77	Professional		$275.32	$364.48	$800.77
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $172.05 / $217.69 / $430.99	Professional	26	$172.05	$217.69	$430.99
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $97.51 / $125.24 / $246.39	Professional	TC	$97.51	$125.24	$246.39
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $115.75 / $279.27 / $510.88	Professional		$115.75	$279.27	$510.88
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $208.62 / $208.62 / $208.62	Facility	26	$208.62	$208.62	$208.62
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $116.06 / $351.63 / $647.55	Professional		$116.06	$351.63	$647.55
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $174.93 / $238.57 / $430.35	Professional	26	$174.93	$238.57	$430.35
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $95.08 / $145.19 / $262.20	Professional	TC	$95.08	$145.19	$262.20
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $167.04 / $179.95 / $179.95	Facility	26	$167.04	$179.95	$179.95
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $272.38 / $276.99 / $294.20	Professional		$272.38	$276.99	$294.20
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $175.89 / $179.95 / $187.37	Professional	26	$175.89	$179.95	$187.37
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $94.98 / $97.05 / $106.84	Professional	TC	$94.98	$97.05	$106.84
United Facility/Professional Professional Modifier Low / Median / High Price $266.14 / $345.14 / $590.41	Professional		$266.14	$345.14	$590.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $172.55 / $228.57 / $379.21	Professional	26	$172.55	$228.57	$379.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $96.89 / $128.40 / $226.19	Professional	TC	$96.89	$128.40	$226.19