Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.45 / $38.00 / $92.83	Facility	26	$26.45	$38.00	$92.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.97 / $70.52 / $119.80	Professional		$54.97	$70.52	$119.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.04 / $28.63 / $56.80	Professional	26	$22.04	$28.63	$56.80
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $22.44 / $30.43 / $44.33	Professional	52	$22.44	$30.43	$44.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.01 / $41.70 / $71.43	Professional	TC	$30.01	$41.70	$71.43
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.49 / $52.49 / $52.49	Professional		$52.49	$52.49	$52.49
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $66.19 / $68.68 / $134.02	Professional		$66.19	$68.68	$134.02
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $29.96 / $48.09 / $66.78	Professional	26	$29.96	$48.09	$66.78
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $66.19 / $102.99 / $240.58	Professional	50	$66.19	$102.99	$240.58
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $36.22 / $53.72 / $92.48	Professional	TC	$36.22	$53.72	$92.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.84 / $33.84 / $33.84	Facility	26	$33.84	$33.84	$33.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.43 / $93.63 / $142.72	Professional		$55.43	$93.63	$142.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.02 / $36.40 / $58.85	Professional	26	$24.02	$36.40	$58.85
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $85.56 / $85.56 / $97.82	Professional	50	$85.56	$85.56	$97.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.61 / $56.17 / $87.99	Professional	TC	$32.61	$56.17	$87.99
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $79.23 / $94.20 / $160.76	Professional		$79.23	$94.20	$160.76
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.32 / $43.66 / $68.23	Professional	26	$34.32	$43.66	$68.23
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.31 / $58.25 / $92.52	Professional	TC	$45.31	$58.25	$92.52
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.72 / $36.72 / $36.72	Professional	26	$36.72	$36.72	$36.72
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $29.01 / $54.25 / $94.86	Facility	26	$29.01	$54.25	$94.86
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $58.25 / $79.95 / $145.99	Professional		$58.25	$79.95	$145.99
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $25.48 / $30.91 / $68.63	Professional	26	$25.48	$30.91	$68.63
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $27.49 / $32.39 / $61.21	Professional	52	$27.49	$32.39	$61.21
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $31.76 / $47.41 / $85.66	Professional	TC	$31.76	$47.41	$85.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $96.30 / $100.30 / $178.20	Professional		$96.30	$100.30	$178.20
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $33.84 / $33.84 / $33.84	Facility	26	$33.84	$33.84	$33.84
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $58.73 / $91.35 / $137.01	Professional		$58.73	$91.35	$137.01
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.33 / $36.40 / $58.85	Professional	26	$24.33	$36.40	$58.85
Priority Health Facility/Professional Professional Modifier 50 Low / Median / High Price $85.56 / $97.82 / $97.82	Professional	50	$85.56	$97.82	$97.82
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.18 / $55.34 / $87.73	Professional	TC	$34.18	$55.34	$87.73
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $29.21 / $29.36 / $29.36	Facility	26	$29.21	$29.36	$29.36
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $63.83 / $64.76 / $88.10	Professional		$63.83	$64.76	$88.10
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $28.80 / $29.36 / $30.68	Professional	26	$28.80	$29.36	$30.68
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $34.65 / $35.40 / $58.89	Professional	TC	$34.65	$35.40	$58.89
United Facility/Professional Professional Modifier Low / Median / High Price $54.38 / $75.20 / $121.39	Professional		$54.38	$75.20	$121.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.80 / $32.65 / $57.73	Professional	26	$24.80	$32.65	$57.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.45 / $41.95 / $67.78	Professional	TC	$30.45	$41.95	$67.78