Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.55 / $38.29 / $60.50	Facility	26	$30.55	$38.29	$60.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.51 / $99.53 / $488.00	Professional		$66.51	$99.53	$488.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.85 / $30.56 / $87.01	Professional	26	$24.85	$30.56	$87.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.50 / $71.90 / $256.93	Professional	TC	$42.50	$71.90	$256.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.81 / $75.64 / $96.78	Professional		$60.81	$75.64	$96.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.87 / $29.62 / $42.26	Professional	26	$20.87	$29.62	$42.26
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $98.71 / $102.43 / $177.88	Professional		$98.71	$102.43	$177.88
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $27.52 / $45.08 / $60.90	Professional	26	$27.52	$45.08	$60.90
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $71.20 / $73.89 / $124.15	Professional	TC	$71.20	$73.89	$124.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.27 / $31.27 / $31.27	Facility	26	$31.27	$31.27	$31.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.54 / $117.92 / $197.23	Professional		$75.54	$117.92	$197.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.53 / $33.11 / $54.19	Professional	26	$19.53	$33.11	$54.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.43 / $83.96 / $138.47	Professional	TC	$54.43	$83.96	$138.47
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $113.63 / $138.30 / $189.38	Professional		$113.63	$138.30	$189.38
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.14 / $36.15 / $57.02	Professional	26	$30.14	$36.15	$57.02
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $85.26 / $106.04 / $150.96	Professional	TC	$85.26	$106.04	$150.96
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.16 / $126.68 / $134.25	Professional		$115.16	$126.68	$134.25
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.72 / $32.24 / $45.21	Professional	26	$28.72	$32.24	$45.21
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $110.21 / $110.21 / $110.21	Professional	TC	$110.21	$110.21	$110.21
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $30.55 / $39.19 / $96.57	Facility	26	$30.55	$39.19	$96.57
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $73.48 / $117.07 / $465.00	Professional		$73.48	$117.07	$465.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $25.85 / $35.67 / $80.51	Professional	26	$25.85	$35.67	$80.51
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $48.36 / $83.96 / $200.62	Professional	TC	$48.36	$83.96	$200.62
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $29.23 / $101.76 / $182.46	Professional		$29.23	$101.76	$182.46
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $31.27 / $31.27 / $31.27	Facility	26	$31.27	$31.27	$31.27
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $81.81 / $117.98 / $199.95	Professional		$81.81	$117.98	$199.95
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.94 / $33.06 / $54.77	Professional	26	$19.94	$33.06	$54.77
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $58.37 / $84.01 / $141.34	Professional	TC	$58.37	$84.01	$141.34
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $26.50 / $27.52 / $27.52	Facility	26	$26.50	$27.52	$27.52
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $97.48 / $98.97 / $109.00	Professional		$97.48	$98.97	$109.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $26.50 / $27.52 / $28.56	Professional	26	$26.50	$27.52	$28.56
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $69.90 / $71.44 / $82.50	Professional	TC	$69.90	$71.44	$82.50
United Facility/Professional Professional Modifier Low / Median / High Price $81.15 / $106.46 / $186.55	Professional		$81.15	$106.46	$186.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.15 / $32.35 / $53.64	Professional	26	$25.15	$32.35	$53.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.07 / $82.85 / $134.91	Professional	TC	$62.07	$82.85	$134.91