Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.79 / $36.58 / $88.93	Facility	26	$27.79	$36.58	$88.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.73 / $116.63 / $225.70	Professional		$90.73	$116.63	$225.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.12 / $26.99 / $58.86	Professional	26	$23.12	$26.99	$58.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.45 / $91.93 / $123.91	Professional	TC	$66.45	$91.93	$123.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.82 / $21.82 / $21.82	Professional	26	$21.82	$21.82	$21.82
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $124.76 / $205.45	Professional		$120.23	$124.76	$205.45
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $27.73 / $28.78 / $53.57	Professional	26	$27.73	$28.78	$53.57
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $92.50 / $95.99 / $160.52	Professional	TC	$92.50	$95.99	$160.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.15 / $32.15 / $32.15	Facility	26	$32.15	$32.15	$32.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.73 / $131.69 / $235.32	Professional		$90.73	$131.69	$235.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.88 / $33.51 / $53.87	Professional	26	$20.88	$33.51	$53.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.02 / $97.63 / $178.37	Professional	TC	$66.02	$97.63	$178.37
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $116.39 / $161.66 / $194.92	Professional		$116.39	$161.66	$194.92
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.67 / $36.75 / $57.40	Professional	26	$30.67	$36.75	$57.40
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $110.67 / $137.84 / $196.37	Professional	TC	$110.67	$137.84	$196.37
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.84 / $30.84 / $30.84	Professional	26	$30.84	$30.84	$30.84
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $27.79 / $50.86 / $90.87	Facility	26	$27.79	$50.86	$90.87
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $90.73 / $127.02 / $281.05	Professional		$90.73	$127.02	$281.05
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $23.81 / $27.89 / $70.31	Professional	26	$23.81	$27.89	$70.31
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $70.56 / $94.69 / $204.80	Professional	TC	$70.56	$94.69	$204.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.34 / $135.00 / $245.90	Professional		$33.34	$135.00	$245.90
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $17.96 / $32.15 / $32.15	Facility	26	$17.96	$32.15	$32.15
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $92.52 / $131.69 / $228.29	Professional		$92.52	$131.69	$228.29
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.36 / $33.33 / $56.38	Professional	26	$21.36	$33.33	$56.38
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $68.89 / $97.63 / $173.66	Professional	TC	$68.89	$97.63	$173.66
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $27.43 / $27.43 / $29.00	Facility	26	$27.43	$27.43	$29.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $109.50 / $125.43 / $136.47	Professional		$109.50	$125.43	$136.47
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $26.70 / $27.47 / $29.00	Professional	26	$26.70	$27.47	$29.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $80.50 / $98.00 / $107.88	Professional	TC	$80.50	$98.00	$107.88
United Facility/Professional Professional Modifier Low / Median / High Price $95.87 / $124.77 / $209.77	Professional		$95.87	$124.77	$209.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.05 / $32.64 / $56.09	Professional	26	$25.05	$32.64	$56.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.20 / $97.37 / $168.14	Professional	TC	$72.20	$97.37	$168.14