Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.09 / $33.24 / $84.45	Facility	26	$24.09	$33.24	$84.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.25 / $116.94 / $234.94	Professional		$90.25	$116.94	$234.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.74 / $25.68 / $45.77	Professional	26	$21.74	$25.68	$45.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.90 / $91.95 / $178.18	Professional	TC	$69.90	$91.95	$178.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.32 / $23.49 / $35.40	Professional	26	$20.32	$23.49	$35.40
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $124.68 / $156.77 / $207.01	Professional		$124.68	$156.77	$207.01
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $26.78 / $43.38 / $62.69	Professional	26	$26.78	$43.38	$62.69
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $97.89 / $111.80 / $163.19	Professional	TC	$97.89	$111.80	$163.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.37 / $30.37 / $30.37	Facility	26	$30.37	$30.37	$30.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.53 / $135.26 / $232.57	Professional		$91.53	$135.26	$232.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $32.75 / $53.11	Professional	26	$20.42	$32.75	$53.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.34 / $102.40 / $180.42	Professional	TC	$67.34	$102.40	$180.42
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $125.21 / $167.71 / $201.98	Professional		$125.21	$167.71	$201.98
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.46 / $35.39 / $55.53	Professional	26	$29.46	$35.39	$55.53
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $117.13 / $145.90 / $207.86	Professional	TC	$117.13	$145.90	$207.86
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.01 / $29.38 / $42.44	Professional	26	$29.01	$29.38	$42.44
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $24.09 / $34.93 / $86.30	Facility	26	$24.09	$34.93	$86.30
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $97.57 / $130.46 / $288.66	Professional		$97.57	$130.46	$288.66
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $22.74 / $27.18 / $69.88	Professional	26	$22.74	$27.18	$69.88
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $82.44 / $104.00 / $232.16	Professional	TC	$82.44	$104.00	$232.16
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $28.43 / $132.38 / $223.66	Professional		$28.43	$132.38	$223.66
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $17.64 / $30.37 / $30.37	Facility	26	$17.64	$30.37	$30.37
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $94.57 / $135.26 / $229.60	Professional		$94.57	$135.26	$229.60
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.44 / $32.75 / $53.22	Professional	26	$20.44	$32.75	$53.22
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $70.63 / $102.37 / $173.66	Professional	TC	$70.63	$102.37	$173.66
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $26.48 / $26.48 / $29.00	Facility	26	$26.48	$26.48	$29.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $109.50 / $126.38 / $137.52	Professional		$109.50	$126.38	$137.52
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $25.76 / $26.54 / $29.00	Professional	26	$25.76	$26.54	$29.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $80.50 / $99.90 / $109.97	Professional	TC	$80.50	$99.90	$109.97
United Facility/Professional Professional Modifier Low / Median / High Price $95.00 / $125.00 / $220.36	Professional		$95.00	$125.00	$220.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.98 / $30.31 / $50.98	Professional	26	$23.98	$30.31	$50.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.18 / $96.62 / $166.86	Professional	TC	$74.18	$96.62	$166.86