Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.37 / $35.82 / $64.48	Facility	26	$31.37	$35.82	$64.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.17 / $107.61 / $400.00	Professional		$92.17	$107.61	$400.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.20 / $32.90 / $77.73	Professional	26	$28.20	$32.90	$77.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.65 / $74.53 / $130.10	Professional	TC	$63.65	$74.53	$130.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.55 / $102.55 / $102.55	Professional		$102.55	$102.55	$102.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.71 / $35.74 / $57.68	Professional	26	$25.71	$35.74	$57.68
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $104.73 / $131.37 / $195.95	Professional		$104.73	$131.37	$195.95
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $33.22 / $43.86 / $65.44	Professional	26	$33.22	$43.86	$65.44
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $71.52 / $87.51 / $134.52	Professional	TC	$71.52	$87.51	$134.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.82 / $37.82 / $37.82	Facility	26	$37.82	$37.82	$37.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.97 / $131.88 / $203.29	Professional		$81.97	$131.88	$203.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.12 / $41.98 / $65.81	Professional	26	$24.12	$41.98	$65.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.46 / $90.09 / $143.10	Professional	TC	$58.46	$90.09	$143.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $119.27 / $145.38 / $176.93	Professional		$119.27	$145.38	$176.93
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.40 / $43.63 / $68.77	Professional	26	$36.40	$43.63	$68.77
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $85.59 / $106.56 / $151.80	Professional	TC	$85.59	$106.56	$151.80
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.02 / $130.91 / $132.90	Professional		$34.02	$130.91	$132.90
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.99 / $39.36 / $49.70	Professional	26	$35.99	$39.36	$49.70
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $29.88 / $43.33 / $104.22	Facility	26	$29.88	$43.33	$104.22
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $98.39 / $117.76 / $337.65	Professional		$98.39	$117.76	$337.65
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $29.87 / $36.63 / $82.45	Professional	26	$29.87	$36.63	$82.45
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $67.45 / $81.89 / $175.24	Professional	TC	$67.45	$81.89	$175.24
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $54.59 / $127.50 / $201.18	Professional		$54.59	$127.50	$201.18
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $37.82 / $37.82 / $37.82	Facility	26	$37.82	$37.82	$37.82
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $82.18 / $131.03 / $203.08	Professional		$82.18	$131.03	$203.08
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.82 / $41.98 / $66.06	Professional	26	$24.82	$41.98	$66.06
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $58.80 / $89.85 / $144.34	Professional	TC	$58.80	$89.85	$144.34
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $32.85 / $32.85 / $38.60	Facility	26	$32.85	$32.85	$38.60
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $106.18 / $107.78 / $116.55	Professional		$106.18	$107.78	$116.55
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $31.99 / $32.89 / $38.60	Professional	26	$31.99	$32.89	$38.60
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $73.30 / $74.92 / $82.48	Professional	TC	$73.30	$74.92	$82.48
United Facility/Professional Professional Modifier Low / Median / High Price $94.59 / $121.47 / $205.02	Professional		$94.59	$121.47	$205.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.58 / $38.96 / $64.87	Professional	26	$31.58	$38.96	$64.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.01 / $82.17 / $133.11	Professional	TC	$63.01	$82.17	$133.11