Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.35 / $16.17 / $27.57	Facility	26	$12.35	$16.17	$27.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.38 / $55.59 / $115.98	Professional		$43.38	$55.59	$115.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.23 / $12.96 / $28.42	Professional	26	$11.23	$12.96	$28.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.14 / $40.33 / $82.01	Professional	TC	$34.14	$40.33	$82.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.10 / $57.50 / $60.38	Professional		$45.10	$57.50	$60.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.42 / $18.29 / $20.96	Professional	26	$10.42	$18.29	$20.96
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $70.19 / $70.19 / $70.19	Professional	TC	$70.19	$70.19	$70.19
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $58.52 / $81.09 / $94.11	Professional		$58.52	$81.09	$94.11
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $13.39 / $21.18 / $26.81	Professional	26	$13.39	$21.18	$26.81
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $45.13 / $58.84 / $71.98	Professional	TC	$45.13	$58.84	$71.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.00 / $15.00 / $15.00	Facility	26	$15.00	$15.00	$15.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.88 / $65.69 / $105.28	Professional		$42.88	$65.69	$105.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.97 / $17.05 / $26.56	Professional	26	$9.97	$17.05	$26.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.52 / $47.81 / $80.55	Professional	TC	$33.52	$47.81	$80.55
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $56.78 / $78.70 / $95.00	Professional		$56.78	$78.70	$95.00
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.76 / $17.66 / $27.68	Professional	26	$14.76	$17.66	$27.68
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $54.03 / $67.23 / $95.74	Professional	TC	$54.03	$67.23	$95.74
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.09 / $66.09 / $90.07	Professional		$66.09	$66.09	$90.07
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.60 / $15.76 / $29.89	Professional	26	$13.60	$15.76	$29.89
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.31 / $67.31 / $67.81	Professional	TC	$67.31	$67.31	$67.81
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $11.77 / $18.82 / $41.02	Facility	26	$11.77	$18.82	$41.02
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $46.93 / $59.58 / $130.05	Professional		$46.93	$59.58	$130.05
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $11.56 / $14.70 / $32.45	Professional	26	$11.56	$14.70	$32.45
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $35.61 / $46.76 / $99.09	Professional	TC	$35.61	$46.76	$99.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.28 / $57.40 / $118.68	Professional		$15.28	$57.40	$118.68
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $15.00 / $15.00 / $15.00	Facility	26	$15.00	$15.00	$15.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $41.91 / $65.69 / $104.75	Professional		$41.91	$65.69	$104.75
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.99 / $17.19 / $26.55	Professional	26	$9.99	$17.19	$26.55
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.52 / $47.81 / $79.97	Professional	TC	$33.52	$47.81	$79.97
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $12.93 / $12.93 / $15.81	Facility	26	$12.93	$12.93	$15.81
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $53.91 / $56.87 / $61.80	Professional		$53.91	$56.87	$61.80
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $12.63 / $12.93 / $15.81	Professional	26	$12.63	$12.93	$15.81
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $38.10 / $43.94 / $48.37	Professional	TC	$38.10	$43.94	$48.37
United Facility/Professional Professional Modifier Low / Median / High Price $46.81 / $59.77 / $101.03	Professional		$46.81	$59.77	$101.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.43 / $15.22 / $25.55	Professional	26	$12.43	$15.22	$25.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.78 / $45.90 / $75.88	Professional	TC	$34.78	$45.90	$75.88