Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.76 / $22.01 / $49.77	Facility	26	$16.76	$22.01	$49.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.64 / $73.29 / $141.91	Professional		$61.64	$73.29	$141.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.53 / $16.54 / $38.09	Professional	26	$14.53	$16.54	$38.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $53.66 / $84.38	Professional	TC	$44.67	$53.66	$84.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.19 / $59.33 / $59.33	Professional		$54.19	$59.33	$59.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.97 / $13.09 / $19.64	Professional	26	$12.97	$13.09	$19.64
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $77.16 / $106.13 / $130.80	Professional		$77.16	$106.13	$130.80
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $17.09 / $27.70 / $33.27	Professional	26	$17.09	$27.70	$33.27
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $60.07 / $77.61 / $97.54	Professional	TC	$60.07	$77.61	$97.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.60 / $19.60 / $19.60	Facility	26	$19.60	$19.60	$19.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.32 / $86.58 / $143.51	Professional		$57.32	$86.58	$143.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.54 / $21.38 / $33.99	Professional	26	$12.54	$21.38	$33.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.36 / $65.17 / $109.87	Professional	TC	$45.36	$65.17	$109.87
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $74.44 / $103.73 / $125.00	Professional		$74.44	$103.73	$125.00
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.73 / $22.59 / $35.54	Professional	26	$18.73	$22.59	$35.54
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $71.95 / $89.45 / $127.34	Professional	TC	$71.95	$89.45	$127.34
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.81 / $96.13 / $96.97	Professional		$89.81	$96.13	$96.97
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.54 / $19.09 / $25.65	Professional	26	$18.54	$19.09	$25.65
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $16.76 / $24.34 / $53.63	Facility	26	$16.76	$24.34	$53.63
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $64.73 / $79.55 / $166.36	Professional		$64.73	$79.55	$166.36
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $14.93 / $17.80 / $40.17	Professional	26	$14.93	$17.80	$40.17
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $48.99 / $61.22 / $123.78	Professional	TC	$48.99	$61.22	$123.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $18.00 / $63.78 / $130.36	Professional		$18.00	$63.78	$130.36
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $19.60 / $19.60 / $19.60	Facility	26	$19.60	$19.60	$19.60
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $57.32 / $86.11 / $143.51	Professional		$57.32	$86.11	$143.51
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.55 / $21.23 / $34.44	Professional	26	$12.55	$21.23	$34.44
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.46 / $64.55 / $109.87	Professional	TC	$45.46	$64.55	$109.87
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $16.91 / $16.91 / $19.32	Facility	26	$16.91	$16.91	$19.32
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $70.61 / $75.70 / $82.29	Professional		$70.61	$75.70	$82.29
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $16.54 / $16.91 / $19.32	Professional	26	$16.54	$16.91	$19.32
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $51.28 / $58.80 / $64.73	Professional	TC	$51.28	$58.80	$64.73
United Facility/Professional Professional Modifier Low / Median / High Price $62.25 / $80.06 / $139.38	Professional		$62.25	$80.06	$139.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.51 / $20.38 / $34.78	Professional	26	$16.51	$20.38	$34.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.82 / $62.87 / $107.02	Professional	TC	$49.82	$62.87	$107.02