Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.97 / $47.04 / $92.63	Facility	26	$39.97	$47.04	$92.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.14 / $133.60 / $629.73	Professional		$109.14	$133.60	$629.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.91 / $41.39 / $90.14	Professional	26	$29.91	$41.39	$90.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.23 / $91.98 / $177.96	Professional	TC	$79.23	$91.98	$177.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.79 / $107.65 / $129.52	Professional		$81.79	$107.65	$129.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $32.59 / $39.61 / $69.68	Professional	26	$32.59	$39.61	$69.68
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $132.25 / $166.02 / $229.58	Professional		$132.25	$166.02	$229.58
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $42.29 / $55.44 / $80.47	Professional	26	$42.29	$55.44	$80.47
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $89.95 / $104.80 / $165.56	Professional	TC	$89.95	$104.80	$165.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.64 / $48.64 / $48.64	Facility	26	$48.64	$48.64	$48.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.08 / $155.25 / $257.55	Professional		$101.08	$155.25	$257.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.92 / $44.45 / $76.16	Professional	26	$29.92	$44.45	$76.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.44 / $110.31 / $179.94	Professional	TC	$69.44	$110.31	$179.94
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $127.73 / $176.05 / $211.20	Professional		$127.73	$176.05	$211.20
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.27 / $55.55 / $87.74	Professional	26	$46.27	$55.55	$87.74
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $107.64 / $134.05 / $190.96	Professional	TC	$107.64	$134.05	$190.96
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $168.44 / $168.44 / $168.44	Professional		$168.44	$168.44	$168.44
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.86 / $48.12 / $62.03	Professional	26	$42.86	$48.12	$62.03
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $38.07 / $54.44 / $122.92	Facility	26	$38.07	$54.44	$122.92
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $118.89 / $145.11 / $430.97	Professional		$118.89	$145.11	$430.97
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $34.13 / $50.20 / $90.56	Professional	26	$34.13	$50.20	$90.56
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $79.76 / $103.71 / $224.83	Professional	TC	$79.76	$103.71	$224.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $122.70 / $122.70 / $390.00	Professional		$122.70	$122.70	$390.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $22.69 / $48.64 / $48.64	Facility	26	$22.69	$48.64	$48.64
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $102.15 / $155.25 / $247.62	Professional		$102.15	$155.25	$247.62
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.07 / $44.69 / $76.16	Professional	26	$30.07	$44.69	$76.16
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $69.64 / $110.31 / $171.46	Professional	TC	$69.64	$110.31	$171.46
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $38.00 / $41.84 / $41.84	Facility	26	$38.00	$41.84	$41.84
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $133.97 / $136.05 / $150.00	Professional		$133.97	$136.05	$150.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $38.00 / $41.84 / $43.36	Professional	26	$38.00	$41.84	$43.36
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $92.15 / $94.21 / $112.00	Professional	TC	$92.15	$94.21	$112.00
United Facility/Professional Professional Modifier Low / Median / High Price $98.86 / $140.75 / $253.26	Professional		$98.86	$140.75	$253.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.99 / $46.19 / $83.44	Professional	26	$32.99	$46.19	$83.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.31 / $100.27 / $166.29	Professional	TC	$75.31	$100.27	$166.29