Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.76 / $35.90 / $72.47	Facility	26	$24.76	$35.90	$72.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.47 / $79.34 / $280.02	Professional		$48.47	$79.34	$280.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.46 / $32.20 / $108.68	Professional	26	$23.46	$32.20	$108.68
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $24.24 / $30.51 / $412.91	Professional	52	$24.24	$30.51	$412.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.10 / $50.92 / $114.40	Professional	TC	$25.10	$50.92	$114.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.03 / $46.63 / $107.12	Professional		$35.03	$46.63	$107.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.63 / $26.63 / $44.81	Professional	26	$9.63	$26.63	$44.81
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $8.76 / $38.31 / $57.96	Professional	52	$8.76	$38.31	$57.96
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.74 / $22.74 / $22.74	Professional	TC	$22.74	$22.74	$22.74
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $56.77 / $58.92 / $157.28	Professional		$56.77	$58.92	$157.28
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $27.22 / $43.18 / $63.58	Professional	26	$27.22	$43.18	$63.58
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $29.56 / $49.27 / $107.89	Professional	TC	$29.56	$49.27	$107.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.97 / $30.97 / $30.97	Facility	26	$30.97	$30.97	$30.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.02 / $91.90 / $153.35	Professional		$56.02	$91.90	$153.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.72 / $33.33 / $54.47	Professional	26	$21.72	$33.33	$54.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.28 / $58.38 / $100.81	Professional	TC	$29.28	$58.38	$100.81
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $67.55 / $88.02 / $137.03	Professional		$67.55	$88.02	$137.03
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.79 / $39.29 / $61.46	Professional	26	$30.79	$39.29	$61.46
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.99 / $47.56 / $75.56	Professional	TC	$36.99	$47.56	$75.56
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.14 / $68.06 / $72.70	Professional		$64.14	$68.06	$72.70
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.92 / $32.49 / $45.53	Professional	26	$15.92	$32.49	$45.53
Highmark BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $32.07 / $32.07 / $34.04	Professional	52	$32.07	$32.07	$34.04
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $24.76 / $38.77 / $85.26	Facility	26	$24.76	$38.77	$85.26
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $51.35 / $85.83 / $245.08	Professional		$51.35	$85.83	$245.08
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $24.32 / $36.43 / $80.13	Professional	26	$24.32	$36.43	$80.13
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $24.24 / $37.22 / $351.00	Professional	52	$24.24	$37.22	$351.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $26.58 / $49.22 / $124.07	Professional	TC	$26.58	$49.22	$124.07
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.75 / $97.50 / $165.90	Professional		$33.75	$97.50	$165.90
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $30.97 / $30.97 / $30.97	Facility	26	$30.97	$30.97	$30.97
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $56.02 / $89.81 / $151.81	Professional		$56.02	$89.81	$151.81
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.86 / $33.13 / $54.47	Professional	26	$21.86	$33.13	$54.47
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.59 / $58.38 / $99.33	Professional	TC	$30.59	$58.38	$99.33
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $27.23 / $27.23 / $30.00	Facility	26	$27.23	$27.23	$30.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $54.09 / $55.04 / $80.00	Professional		$54.09	$55.04	$80.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $26.47 / $27.31 / $30.00	Professional	26	$26.47	$27.31	$30.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $27.25 / $27.81 / $50.00	Professional	TC	$27.25	$27.81	$50.00
United Facility/Professional Professional Modifier Low / Median / High Price $61.42 / $84.46 / $148.66	Professional		$61.42	$84.46	$148.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.28 / $30.82 / $53.54	Professional	26	$23.28	$30.82	$53.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.34 / $54.49 / $90.13	Professional	TC	$36.34	$54.49	$90.13