Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.42 / $18.37 / $45.60	Facility	26	$14.42	$18.37	$45.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.93 / $42.78 / $72.19	Professional		$33.93	$42.78	$72.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.00 / $14.68 / $43.29	Professional	26	$13.00	$14.68	$43.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.00 / $27.22 / $54.11	Professional	TC	$21.00	$27.22	$54.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.45 / $13.30 / $26.52	Professional	26	$11.45	$13.30	$26.52
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $40.22 / $60.02 / $95.21	Professional		$40.22	$60.02	$95.21
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $15.10 / $24.48 / $37.22	Professional	26	$15.10	$24.48	$37.22
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $25.11 / $34.47 / $66.89	Professional	TC	$25.11	$34.47	$66.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.36 / $17.36 / $17.36	Facility	26	$17.36	$17.36	$17.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.90 / $59.24 / $109.61	Professional		$32.90	$59.24	$109.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.49 / $18.93 / $29.80	Professional	26	$11.49	$18.93	$29.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.70 / $38.56 / $79.97	Professional	TC	$20.70	$38.56	$79.97
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $48.29 / $61.48 / $84.44	Professional		$48.29	$61.48	$84.44
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.55 / $19.80 / $31.24	Professional	26	$16.55	$19.80	$31.24
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.09 / $37.38 / $53.20	Professional	TC	$30.09	$37.38	$53.20
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.26 / $17.54 / $24.83	Professional	26	$8.26	$17.54	$24.83
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $14.42 / $26.41 / $47.19	Facility	26	$14.42	$26.41	$47.19
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $35.56 / $53.87 / $120.96	Professional		$35.56	$53.87	$120.96
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $13.31 / $18.66 / $44.27	Professional	26	$13.31	$18.66	$44.27
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $22.22 / $33.15 / $78.11	Professional	TC	$22.22	$33.15	$78.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $21.70 / $54.90 / $86.40	Professional		$21.70	$54.90	$86.40
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $10.55 / $17.36 / $17.36	Facility	26	$10.55	$17.36	$17.36
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $33.15 / $58.78 / $102.99	Professional		$33.15	$58.78	$102.99
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.49 / $18.92 / $30.67	Professional	26	$11.49	$18.92	$30.67
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.71 / $37.50 / $79.59	Professional	TC	$20.71	$37.50	$79.59
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $14.94 / $14.94 / $17.50	Facility	26	$14.94	$14.94	$17.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $39.33 / $39.90 / $58.00	Professional		$39.33	$39.90	$58.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $14.53 / $14.96 / $17.50	Professional	26	$14.53	$14.96	$17.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $24.47 / $24.97 / $40.50	Professional	TC	$24.47	$24.97	$40.50
United Facility/Professional Professional Modifier Low / Median / High Price $35.14 / $49.54 / $81.53	Professional		$35.14	$49.54	$81.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.36 / $17.87 / $30.15	Professional	26	$14.36	$17.87	$30.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.17 / $28.53 / $56.78	Professional	TC	$21.17	$28.53	$56.78