Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.63 / $31.70 / $61.71	Facility	26	$26.63	$31.70	$61.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.68 / $95.86 / $447.89	Professional		$81.68	$95.86	$447.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.66 / $28.52 / $64.84	Professional	26	$20.66	$28.52	$64.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.71 / $69.95 / $127.53	Professional	TC	$56.71	$69.95	$127.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.75 / $71.53 / $91.16	Professional		$57.75	$71.53	$91.16
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.51 / $23.90 / $49.48	Professional	26	$21.51	$23.90	$49.48
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $93.04 / $115.99 / $160.63	Professional		$93.04	$115.99	$160.63
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $28.51 / $42.30 / $53.38	Professional	26	$28.51	$42.30	$53.38
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $64.52 / $75.38 / $116.99	Professional	TC	$64.52	$75.38	$116.99
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $32.40 / $32.40	Facility	26	$32.40	$32.40	$32.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.04 / $109.30 / $180.82	Professional		$71.04	$109.30	$180.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.20 / $29.85 / $51.90	Professional	26	$20.20	$29.85	$51.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.54 / $77.90 / $128.61	Professional	TC	$49.54	$77.90	$128.61
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $90.81 / $124.07 / $149.06	Professional		$90.81	$124.07	$149.06
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.24 / $37.49 / $59.11	Professional	26	$31.24	$37.49	$59.11
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $77.22 / $96.14 / $136.93	Professional	TC	$77.22	$96.14	$136.93
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.16 / $117.95 / $117.95	Professional		$117.16	$117.95	$117.95
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.78 / $31.22 / $41.51	Professional	26	$26.78	$31.22	$41.51
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $25.65 / $36.65 / $83.10	Facility	26	$25.65	$36.65	$83.10
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $83.15 / $104.55 / $258.01	Professional		$83.15	$104.55	$258.01
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $22.87 / $33.40 / $62.59	Professional	26	$22.87	$33.40	$62.59
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $61.22 / $75.30 / $163.61	Professional	TC	$61.22	$75.30	$163.61
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $47.34 / $85.90 / $183.10	Professional		$47.34	$85.90	$183.10
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $15.04 / $32.40 / $32.40	Facility	26	$15.04	$32.40	$32.40
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $72.70 / $109.30 / $174.45	Professional		$72.70	$109.30	$174.45
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.35 / $29.83 / $51.90	Professional	26	$20.35	$29.83	$51.90
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $49.76 / $78.42 / $122.55	Professional	TC	$49.76	$78.42	$122.55
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $25.00 / $28.52 / $28.52	Facility	26	$25.00	$28.52	$28.52
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $81.00 / $95.85 / $103.72	Professional		$81.00	$95.85	$103.72
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $25.00 / $28.57 / $29.60	Professional	26	$25.00	$28.57	$29.60
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $56.00 / $67.33 / $74.13	Professional	TC	$56.00	$67.33	$74.13
United Facility/Professional Professional Modifier Low / Median / High Price $70.19 / $97.80 / $176.90	Professional		$70.19	$97.80	$176.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.34 / $30.68 / $55.59	Professional	26	$22.34	$30.68	$55.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.24 / $69.66 / $123.50	Professional	TC	$52.24	$69.66	$123.50