Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $443.58 / $919.44 / $1,489.40	Facility		$443.58	$919.44	$1,489.40
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $246.46 / $599.41 / $707.30	Facility	26	$246.46	$599.41	$707.30
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $265.38 / $697.73 / $2,083.62	Facility	TC	$265.38	$697.73	$2,083.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $313.08 / $508.56 / $969.92	Professional		$313.08	$508.56	$969.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $143.80 / $178.20 / $467.10	Professional	26	$143.80	$178.20	$467.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $154.59 / $299.89 / $650.52	Professional	TC	$154.59	$299.89	$650.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $258.87 / $258.87 / $318.27	Professional	26	$258.87	$258.87	$318.27
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $357.36 / $370.84 / $604.88	Professional		$357.36	$370.84	$604.88
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $173.01 / $179.54 / $293.60	Professional	26	$173.01	$179.54	$293.60
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $184.34 / $191.30 / $311.27	Professional	TC	$184.34	$191.30	$311.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $313.23 / $313.23 / $845.83	Facility		$313.23	$313.23	$845.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $197.83 / $197.83 / $197.83	Facility	26	$197.83	$197.83	$197.83
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $215.75 / $215.75 / $215.75	Facility	TC	$215.75	$215.75	$215.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $326.16 / $326.16 / $326.16	Professional		$326.16	$326.16	$326.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $153.56 / $153.56 / $153.56	Professional	26	$153.56	$153.56	$153.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $172.60 / $172.60 / $172.60	Professional	TC	$172.60	$172.60	$172.60
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $423.18 / $527.29 / $1,017.07	Professional		$423.18	$527.29	$1,017.07
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $192.83 / $239.48 / $458.73	Professional	26	$192.83	$239.48	$458.73
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $230.36 / $287.81 / $558.34	Professional	TC	$230.36	$287.81	$558.34
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $391.71 / $391.71 / $490.50	Professional		$391.71	$391.71	$490.50
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $174.78 / $200.56 / $253.23	Professional	26	$174.78	$200.56	$253.23
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $509.06 / $919.44 / $1,433.15	Facility		$509.06	$919.44	$1,433.15
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $246.46 / $707.30 / $707.30	Facility	26	$246.46	$707.30	$707.30
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $262.60 / $697.73 / $2,083.62	Facility	TC	$262.60	$697.73	$2,083.62
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $313.08 / $508.56 / $1,433.15	Professional		$313.08	$508.56	$1,433.15
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $158.50 / $218.71 / $496.47	Professional	26	$158.50	$218.71	$496.47
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $154.59 / $265.38 / $725.85	Professional	TC	$154.59	$265.38	$725.85
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $171.71 / $314.27 / $648.80	Professional		$171.71	$314.27	$648.80
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $313.23 / $313.23 / $845.83	Facility		$313.23	$313.23	$845.83
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $197.83 / $197.83 / $197.83	Facility	26	$197.83	$197.83	$197.83
Priority Health Facility/Professional Facility Modifier TC Low / Median / High Price $215.75 / $215.75 / $215.75	Facility	TC	$215.75	$215.75	$215.75
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $326.16 / $326.16 / $326.16	Professional		$326.16	$326.16	$326.16
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $153.56 / $153.56 / $153.56	Professional	26	$153.56	$153.56	$153.56
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $172.60 / $172.60 / $172.60	Professional	TC	$172.60	$172.60	$172.60
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $342.55 / $353.95 / $556.35	Professional		$342.55	$353.95	$556.35
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $168.81 / $170.51 / $177.62	Professional	26	$168.81	$170.51	$177.62
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $172.04 / $179.27 / $387.54	Professional	TC	$172.04	$179.27	$387.54
United Facility/Professional Facility Modifier Low / Median / High Price $1,056.93 / $1,056.93 / $1,113.41	Facility		$1,056.93	$1,056.93	$1,113.41
United Facility/Professional Professional Modifier Low / Median / High Price $217.96 / $350.23 / $635.08	Professional		$217.96	$350.23	$635.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $99.84 / $182.05 / $315.45	Professional	26	$99.84	$182.05	$315.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $105.28 / $173.91 / $338.10	Professional	TC	$105.28	$173.91	$338.10