Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.32 / $17.13 / $40.92	Facility	26	$13.32	$17.13	$40.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.03 / $67.66 / $207.18	Professional		$54.03	$67.66	$207.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.69 / $17.39 / $47.19	Professional	26	$12.69	$17.39	$47.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.02 / $47.74 / $127.78	Professional	TC	$39.02	$47.74	$127.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $37.46 / $44.31 / $58.79	Professional		$37.46	$44.31	$58.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.20 / $13.73 / $23.83	Professional	26	$11.20	$13.73	$23.83
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $34.97 / $34.97 / $56.33	Professional	TC	$34.97	$34.97	$56.33
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $59.87 / $88.10 / $103.93	Professional		$59.87	$88.10	$103.93
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $14.42 / $23.36 / $42.30	Professional	26	$14.42	$23.36	$42.30
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $45.45 / $62.01 / $74.56	Professional	TC	$45.45	$62.01	$74.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.57 / $16.57 / $16.57	Facility	26	$16.57	$16.57	$16.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.57 / $75.03 / $115.96	Professional		$47.57	$75.03	$115.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.58 / $20.71 / $33.59	Professional	26	$11.58	$20.71	$33.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.47 / $53.69 / $87.54	Professional	TC	$34.47	$53.69	$87.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $70.25 / $82.25 / $96.92	Professional		$70.25	$82.25	$96.92
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.84 / $18.95 / $29.81	Professional	26	$15.84	$18.95	$29.81
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $54.41 / $67.70 / $96.43	Professional	TC	$54.41	$67.70	$96.43
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.03 / $69.59 / $75.94	Professional		$69.03	$69.59	$75.94
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.93 / $17.37 / $24.64	Professional	26	$14.93	$17.37	$24.64
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.24 / $57.79 / $83.06	Professional	TC	$53.24	$57.79	$83.06
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $13.32 / $18.39 / $45.06	Facility	26	$13.32	$18.39	$45.06
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $54.04 / $75.68 / $188.09	Professional		$54.04	$75.68	$188.09
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $19.04 / $46.45	Professional	26	$12.88	$19.04	$46.45
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $41.30 / $55.07 / $136.59	Professional	TC	$41.30	$55.07	$136.59
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.32 / $62.36 / $104.99	Professional		$15.32	$62.36	$104.99
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $11.98 / $16.57 / $16.57	Facility	26	$11.98	$16.57	$16.57
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $48.66 / $73.42 / $115.96	Professional		$48.66	$73.42	$115.96
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.71 / $20.21 / $33.59	Professional	26	$11.71	$20.21	$33.59
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.94 / $54.63 / $87.73	Professional	TC	$35.94	$54.63	$87.73
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $14.26 / $14.26 / $19.50	Facility	26	$14.26	$14.26	$19.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $58.84 / $59.78 / $64.91	Professional		$58.84	$59.78	$64.91
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $13.87 / $14.29 / $19.50	Professional	26	$13.87	$14.29	$19.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $44.55 / $45.52 / $50.11	Professional	TC	$44.55	$45.52	$50.11
United Facility/Professional Professional Modifier Low / Median / High Price $51.45 / $65.75 / $111.39	Professional		$51.45	$65.75	$111.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.71 / $17.46 / $28.52	Professional	26	$13.71	$17.46	$28.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.74 / $48.37 / $82.36	Professional	TC	$37.74	$48.37	$82.36