Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.95 / $16.42 / $30.89	Facility	26	$13.95	$16.42	$30.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.50 / $60.35 / $232.80	Professional		$50.50	$60.35	$232.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.86 / $15.66 / $66.40	Professional	26	$12.86	$15.66	$66.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.11 / $43.09 / $81.43	Professional	TC	$37.11	$43.09	$81.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.52 / $45.92 / $113.00	Professional		$41.52	$45.92	$113.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.70 / $15.64 / $23.15	Professional	26	$11.70	$15.64	$23.15
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $55.54 / $69.70 / $78.23	Professional	TC	$55.54	$69.70	$78.23
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $59.89 / $88.67 / $102.02	Professional		$59.89	$88.67	$102.02
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $15.07 / $24.42 / $30.08	Professional	26	$15.07	$24.42	$30.08
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $44.82 / $63.07 / $73.01	Professional	TC	$44.82	$63.07	$73.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.32 / $17.32 / $17.32	Facility	26	$17.32	$17.32	$17.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.20 / $70.48 / $112.64	Professional		$45.20	$70.48	$112.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.15 / $19.19 / $29.83	Professional	26	$11.15	$19.19	$29.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.56 / $50.27 / $82.98	Professional	TC	$34.56	$50.27	$82.98
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $62.21 / $80.34 / $96.85	Professional		$62.21	$80.34	$96.85
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.57 / $19.86 / $31.20	Professional	26	$16.57	$19.86	$31.20
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $53.66 / $66.76 / $95.06	Professional	TC	$53.66	$66.76	$95.06
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.30 / $71.03 / $88.12	Professional		$68.30	$71.03	$88.12
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.52 / $17.54 / $22.18	Professional	26	$16.52	$17.54	$22.18
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $56.96 / $66.28 / $80.80	Professional	TC	$56.96	$66.28	$80.80
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $13.95 / $18.57 / $45.66	Facility	26	$13.95	$18.57	$45.66
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $51.49 / $68.58 / $163.19	Professional		$51.49	$68.58	$163.19
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $13.29 / $16.75 / $44.21	Professional	26	$13.29	$16.75	$44.21
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $37.93 / $49.67 / $89.77	Professional	TC	$37.93	$49.67	$89.77
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $17.21 / $62.90 / $117.86	Professional		$17.21	$62.90	$117.86
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $17.32 / $17.32 / $17.32	Facility	26	$17.32	$17.32	$17.32
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $70.27 / $112.64	Professional		$44.67	$70.27	$112.64
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.26 / $19.32 / $29.83	Professional	26	$11.26	$19.32	$29.83
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.82 / $50.27 / $82.08	Professional	TC	$33.82	$50.27	$82.08
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $14.91 / $14.91 / $17.75	Facility	26	$14.91	$14.91	$17.75
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $58.56 / $59.48 / $64.56	Professional		$58.56	$59.48	$64.56
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $14.52 / $14.93 / $17.75	Professional	26	$14.52	$14.93	$17.75
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $41.39 / $44.57 / $49.07	Professional	TC	$41.39	$44.57	$49.07
United Facility/Professional Professional Modifier Low / Median / High Price $51.17 / $64.86 / $109.26	Professional		$51.17	$64.86	$109.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.34 / $17.64 / $29.83	Professional	26	$14.34	$17.64	$29.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.83 / $47.07 / $77.37	Professional	TC	$36.83	$47.07	$77.37