Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.04 / $53.79 / $144.35	Facility	26	$39.04	$53.79	$144.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.06 / $102.05 / $188.91	Professional		$81.06	$102.05	$188.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.71 / $40.79 / $78.87	Professional	26	$15.71	$40.79	$78.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.02 / $57.12 / $174.04	Professional	TC	$42.02	$57.12	$174.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.61 / $35.60 / $86.32	Professional	26	$34.61	$35.60	$86.32
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $93.75 / $97.28 / $97.28	Professional		$93.75	$97.28	$97.28
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $28.10 / $45.75 / $74.58	Professional	26	$28.10	$45.75	$74.58
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $48.00 / $49.81 / $126.58	Professional	TC	$48.00	$49.81	$126.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.72 / $52.72 / $52.72	Facility	26	$52.72	$52.72	$52.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.31 / $168.40 / $547.94	Professional		$77.31	$168.40	$547.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.71 / $30.18 / $73.25	Professional	26	$17.71	$30.18	$73.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.69 / $107.92 / $519.72	Professional	TC	$42.69	$107.92	$519.72
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $111.25 / $143.38 / $638.96	Professional		$111.25	$143.38	$638.96
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.01 / $59.64 / $94.42	Professional	26	$50.01	$59.64	$94.42
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $57.45 / $71.50 / $101.82	Professional	TC	$57.45	$71.50	$101.82
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.01 / $56.48 / $75.03	Professional	26	$51.01	$56.48	$75.03
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $41.38 / $59.17 / $147.51	Facility	26	$41.38	$59.17	$147.51
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $85.90 / $125.59 / $290.07	Professional		$85.90	$125.59	$290.07
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $17.39 / $45.11 / $96.53	Professional	26	$17.39	$45.11	$96.53
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $44.52 / $67.42 / $198.30	Professional	TC	$44.52	$67.42	$198.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $61.08 / $258.00 / $628.20	Professional		$61.08	$258.00	$628.20
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $11.98 / $52.72 / $52.72	Facility	26	$11.98	$52.72	$52.72
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $77.31 / $151.11 / $547.94	Professional		$77.31	$151.11	$547.94
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.96 / $30.18 / $73.25	Professional	26	$17.96	$30.18	$73.25
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $103.52 / $522.10	Professional	TC	$44.67	$103.52	$522.10
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $45.53 / $45.53 / $58.50	Facility	26	$45.53	$45.53	$58.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $92.57 / $94.22 / $488.35	Professional		$92.57	$94.22	$488.35
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $44.17 / $45.76 / $58.50	Professional	26	$44.17	$45.76	$58.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $47.65 / $48.68 / $429.85	Professional	TC	$47.65	$48.68	$429.85
United Facility/Professional Professional Modifier Low / Median / High Price $94.66 / $136.72 / $439.25	Professional		$94.66	$136.72	$439.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.51 / $49.04 / $90.48	Professional	26	$17.51	$49.04	$90.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.52 / $72.98 / $297.66	Professional	TC	$50.52	$72.98	$297.66