Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.67 / $53.52 / $123.78	Facility	26	$41.67	$53.52	$123.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.56 / $92.40 / $400.67	Professional		$67.56	$92.40	$400.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.07 / $39.78 / $197.86	Professional	26	$34.07	$39.78	$197.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.47 / $49.65 / $141.05	Professional	TC	$31.47	$49.65	$141.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.95 / $65.52 / $75.45	Professional		$47.95	$65.52	$75.45
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.02 / $53.18 / $70.90	Professional	26	$29.02	$53.18	$70.90
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $80.55 / $114.01	Professional		$77.62	$80.55	$114.01
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $37.58 / $39.00 / $74.06	Professional	26	$37.58	$39.00	$74.06
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $40.04 / $41.56 / $59.55	Professional	TC	$40.04	$41.56	$59.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.19 / $43.19 / $43.19	Facility	26	$43.19	$43.19	$43.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.01 / $115.18 / $218.49	Professional		$63.01	$115.18	$218.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.55 / $47.85 / $74.70	Professional	26	$27.55	$47.85	$74.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.79 / $62.08 / $157.66	Professional	TC	$31.79	$62.08	$157.66
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $92.32 / $108.99 / $171.17	Professional		$92.32	$108.99	$171.17
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.17 / $49.40 / $77.88	Professional	26	$41.17	$49.40	$77.88
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $48.01 / $59.60 / $84.79	Professional	TC	$48.01	$59.60	$84.79
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.06 / $85.87 / $111.65	Professional		$78.06	$85.87	$111.65
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.36 / $41.08 / $63.71	Professional	26	$37.36	$41.08	$63.71
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $41.68 / $63.35 / $133.38	Facility	26	$41.68	$63.35	$133.38
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $67.56 / $98.12 / $328.51	Professional		$67.56	$98.12	$328.51
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $35.45 / $46.92 / $168.35	Professional	26	$35.45	$46.92	$168.35
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $31.47 / $52.51 / $134.38	Professional	TC	$31.47	$52.51	$134.38
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $37.58 / $67.08 / $173.00	Professional		$37.58	$67.08	$173.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $27.58 / $43.19 / $43.19	Facility	26	$27.58	$43.19	$43.19
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $63.39 / $110.34 / $209.23	Professional		$63.39	$110.34	$209.23
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.36 / $47.85 / $75.98	Professional	26	$28.36	$47.85	$75.98
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.73 / $59.86 / $152.06	Professional	TC	$30.73	$59.86	$152.06
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $37.17 / $37.17 / $43.35	Facility	26	$37.17	$37.17	$43.35
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $72.34 / $73.52 / $165.00	Professional		$72.34	$73.52	$165.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $36.22 / $37.17 / $43.35	Professional	26	$36.22	$37.17	$43.35
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $35.59 / $36.35 / $121.65	Professional	TC	$35.59	$36.35	$121.65
United Facility/Professional Professional Modifier Low / Median / High Price $63.44 / $91.64 / $163.63	Professional		$63.44	$91.64	$163.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.92 / $44.74 / $73.97	Professional	26	$35.92	$44.74	$73.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.39 / $41.40 / $101.35	Professional	TC	$27.39	$41.40	$101.35